Cardioversion in patients with newly diagnosed non-valvular atrial fibrillation: Observational study using prospectively collected registry data

Autor: Pope, Marita Knudsen, Hall, Trygve S, Schirripa, Valentina, Radic, Petra, Virdone, Saverio, Pieper, Karen S, Le Heuzey, Jean-Yves, Jansky, Petr, Fitzmaurice, David A, Cappato, Riccardo, Atar, Dan, Camm, A John, Kakkar, Ajay K, Bassand, Jean-Pierre, Fox, Keith A A, Gersh, Bernard J, Goldhaber, Samuel Z, Goto, Shinya, Haas, Sylvia, Hacke, Werner, Mantovani, Lorenzo G, Misselwitz, Frank, Turpie, Alexander G G, van Eickels, Martin, Verheugt, Freek W A, Luciardi, Hector Lucas, Gibbs, Harry, Brodmann, Marianne, Cools, Frank, Barretto, Antonio Carlos Pereira, Connolly, Stuart J, Eikelboom, John, Corbalan, Ramon, Jing, Zhi-Cheng, Nielsen, Jørn Dalsgaard, Ragy, Hany, Raatikainen, Pekka, Darius, Harald, Keltai, Matyas, Sawhney, Jitendra Pal Singh, Agnelli, Giancarlo, Ambrosio, Giuseppe, Koretsune, Yukihiro, Sánchez Díaz, Carlos Jerjes, Ten Cate, Hugo, Stepinska, Janina, Panchenko, Elizaveta, Lim, Toon Wei, Jacobson, Barry, Oh, Seil, Viñolas, Xavier, Rosenqvist, Marten, Steffel, Jan, Angchaisuksiri, Pantep, Oto, Ali, Parkhomenko, Alex, Al Mahmeed, Wael, Hu, Dayi, Chen, Kangning, Zhao, Yusheng, Zhang, Huaiqin, Chen, Jiyan, Cao, Shiping, Wang, Daowen, Yang, Yuejin, Li, Weihua, Li, Hui, Yin, Yuehui, Tao, Guizhou, Yang, Ping, Chen, Yingmin, He, Shenghu, Wang, Yong, Fu, Guosheng, Li, Xin, Wu, Tongguo, Cheng, Xiaoshu, Yan, Xiaowei, Zhao, Ruiping, Chen, Moshui, Xiong, Longgen, Chen, Ping, Jiao, Yang, Guo, Ying, Xue, Li, Yang, Zhiming, Jadhavm, Praveen, Sarma, Raghava, Kulkarni, Govind, Chandwani, Prakash, Pothiwala, Rasesh Atulbhai, Purayil, Mohanan Padinhare, Chawla, Kamaldeep, Kothiwale, Veerappa Annasaheb, Raghuraman, Bagirath, Vijan, Vinod Madan, Sawhney, Jitendra, Bantwal, Ganapathi, Khan, Aziz, Meena, Ramdhan, Chopada, Manojkumar, Abraham, Sunitha, Bisne, Vikas, Vijayaraghavan, Govindan, Roy, Debabrata, Durgaprasad, Rajashekhar, Shankar, A G Ravi, Kumar, Sunil, Jain, Dinesh, Bhargava, Kartikeya, Kumar, Vinay, Nagamalesh, Udigala Madappa, Rajput, Rajeeve Kumar, Kanamori, Seishu, Yamamoto, Kenichi, Kumagai, Koichiro, Katsuda, Yosuke, Yoshida, Keiki, Toyota, Fumitoshi, Mizuno, Yuji, Misumi, Ikuo, Noguchi, Hiroo, Ando, Shinichi, Suetsugu, Tetsuro, Minamoto, Masahiro, Oda, Hiroyuki, Adachi, Susumu, Chiba, Kei, Norita, Hiroaki, Tsuruta, Makoto, Koyanagi, Takeshi, Yamamoto, Kunihiko, Ando, Hiroshi, Higashi, Takayuki, Okada, Megumi, Azakami, Shiro, Komaki, Shinichiro, Kumeda, Kenshi, Murayama, Takashi, Matsumura, Jun, Oba, Yurika, Sonoda, Ryuji, Goto, Kazuo, Minoda, Kotaro, Haraguchi, Yoshikuni, Suefuji, Hisakazu, Miyagi, Hiroo, Kato, Hitoshi, Nakamura, Tsugihiro, Nakamura, Tadashi, Nandate, Hidekazu, Zaitsu, Ryuji, Fujiura, Yoshihisa, Yoshimura, Akira, Numata, Hiroyuki, Ogawa, Jun, Kamogawa, Yasuyuki, Murakami, Kinshiro, Wakasa, Yutaka, Yamasawa, Masanori, Maekawa, Hiromitsu, Abe, Sumihisa, Kihara, Hajime, Tsunoda, Satoru, Saito, Katsumi, Tachibana, Hiroki, Oba, Ichiro, Kuwahata, Takashi, Higa, Satoshi, Gushiken, Masamichi, Eto, Takuma, Chibana, 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Mita, Teruaki, Nagao, Kazuhiko, Mito, Takafumi, Minami, Junichi, Abe, Mitsunori, Fujii, Masako, Okawa, Makoto, Fujito, Tsuneo, Taniguchi, Toshiya, Ko, Tenei, Kubo, Hiroshi, Imamaki, Mizuho, Akiyama, Masahiro, Ueda, Takashi, Odakura, Hironori, Inagaki, Masahiko, Katsube, Yoshiki, Nakata, Atsuyuki, Tomimoto, Shinobu, Shibuya, Mitsuhiro, Nakano, Masayuki, Ito, Kenichiro, Matsuta, Masahiro, Ishiguro, Motoyuki, Minagawa, Taro, Wada, Masamichi, Mukawa, Hiroaki, Mizuguchi, Masato, Okuda, Fumio, Kimura, Teruaki, Taga, Kuniaki, Techigawara, Masaaki, Igarashi, Morio, Watanabe, Hiroshi, Seo, Toshihiko, Hiramitsu, Shinya, Hosokawa, Hiroaki, Hoshiai, Mitsumoto, Hibino, Michitaka, Miyagawa, Koichi, Horie, Hideki, Sugishita, Nobuyoshi, Shiga, Yukio, Soma, Akira, Neya, Kazuo, Yoshida, Tetsuro, Akahane, Kunio, Adachi, Sen, Takanaka, Chiei, Matsui, Saori, Kanda, Hirofumi, Kaneko, Masanori, Nagasaka, Shiro, Taguchi, Atsushi, Toru, Shuta, Saito, Kazuyuki, Miyashita, Akiko, Sasaguri, Hiroki, Nariyama, Jin, 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Ogorek, Michal, Wozakowska-Kaplon, Beata, Loboz-Grudzien, Krystyna, Supinski, Wieslaw, Kuzniar, Jerzy, Zaluska, Roman, Hiczkiewicz, Jaroslaw, Swiatkowska-Byczynska, Lucyna, Kucharski, Lech, Gruchala, Marcin, Minc, Piotr, Olszewski, Maciej, Kania, Grzegorz, Krzciuk, Malgorzata, Lajkowski, Zbigniew, Ostrowska-Pomian, Bozenna, Lewczuk, Jerzy, Zinka, Elzbieta, Karczmarczyk, Agnieszka, Chmielnicka-Pruszczynska, Malgorzata, Wozniak-Skowerska, Iwona, Opolski, Grzegorz, Bronisz, Marek, Ogorek, Marcin, Glanowska, Grazyna, Ruszkowski, Piotr, Skonieczny, Grzegorz, Sciborski, Ryszard, Okopien, Boguslaw, Kukla, Piotr, Galbas, Krzysztof, Cymerman, Krzysztof, Jurowiecki, Jaroslaw, Miekus, Pawel, Myszka, Waldemar, Mazur, Stanislaw, Lysek, Roman, Baszak, Jacek, Rusicka-Piekarz, Teresa, Raczak, Grzegorz, Domanska, Ewa, Nessler, Jadwiga, Lesnik, Jozef, Eltishcheva, Vera, Libis, Roman, Kamalov, Gadel, Belenky, Dmitry, Egorova, Liudmila, Khokhlov, Alexander, Yakupov, Eduard, Zateyshchikov, Dmitry, Barbarash, Olga, Miller, Olga, Mazur, Evgeniy, Zrazhevskiy, Konstantin, Novikova, Tatyana, Moiseeva, Yulia, Polkanova, Elena, Sobolev, Konstantin, Rossovskaya, Maria, Shapovalova, Yulia, Kolesnikova, Alla, Nikolaev, Konstantin, Zemlianskaia, Oksana, Zateyshchikova, Anna, Kostenko, Victor, Popov, Sergey, Poltavskaya, Maria, Edin, Anton, Aleksandrova, Elena, Drapkina, Oksana, Vishnevsky, Alexander, Nagibovich, Oleg, Chizhov, Petr, Rachkova, Svetlana, Sergeev, Mikhail, Kurylo, Borys, Ushakov, Alexey, Vinolas, Xavier, Garcia, Pere Alvarez, Lopez Fernandez, Maria Fernanda, Sanchez, Luis Tercedor, Iparraguirre, Salvador Tranche, Monserrat, Pere Toran, Contreras, Emilio Marquez, Rafecas, Jordi Isart, Carrasco, Juan Motero, Pavia, Pablo Garcia, Pajuelo, Casimiro Gomez, Rincon Diaz, Luis Miguel, Iglesias Alonso, Luis Fernando, Ruiz, Angel Grande, Klein, Jordi Merce, Gonzalez Juanatey, Jose Ramon, Collado, Ines Monte, Piquero, Herminia Palacin, Cuixart, Carles Brotons, Escobar, Esther Fernandez, 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Jan-Erik, Andersson, Agneta, Malmqvist, Lennart, Engdahl, Johan, Thulin, Jörgen, Hot-Bjelak, Aida, Jensen, Steen, Stalby, Per, Debrunner, Johann, Beer, Juerg H, Shah, Dipen, Rudyk, Iurii, Tseluyko, Vira, Karpenko, Oleksandr, Zhurba, Svitlana, Kraiz, Igor, Parkhomenko, Oleksandr, Kupnovytska, Iryna, Seredyuk, Nestor, Mostovoy, Yuriy, Ushakov, Oleksiy, Koval, Olena, Kovalskiy, Igor, Svyshchenko, Yevgeniya, Sychov, Oleg, Stanislavchuk, Mykola, Yagensky, Andriy, Tykhonova, Susanna, Fushtey, Ivan, Murdoch, Will, Chauhan, Naresh, Goodwin, Daryl, Lumley, Louise, Patel, Ramila, Saunders, Philip, Wong, Bennett, Cameron, Alex, Patel, Niranjan, Jhittay, P, Ross, Andrew, Kainth, M S, Ladha, Karim, Douglas, Kevin, Pickavance, Gill, McDonnell, Joanna, Handscombe, Laura, Gooding, Trevor, Wagner, Helga, Bradshaw, Colin, Bromham, Catherine, Jones, Kevin, Suryani, Shoeb, Coates, Richard, Sarai, Bhupinder, Willcock, W, Sircar, S, Cairns, John, Gilliand, A, Bilas, Roman, Strieder, E, Hutchinson, Peter, Wakeman, Anne, Stokes, Michael, Kirby, Graham, Vishwanathan, Bhaskhar, Bird, Nigel, Evans, Paul, Clark, M, Bisatt, John, Litchfield, Jennifer, Fisher, E, Fooks, Tim, Kelsall, Richard, Paul, Neil, Alborough, Elizabeth, Aziz, Michael, Ramesh, C, Wilson, Pete, Franklin, Simon, Fairhead, Sue, Thompson, Julian, Chowan, Hasan, Taylor, Gary, Tragen, Dawn, Parfitt, Matt, Seamark, Claire, Paul, Carolyn, Richardson, Mark, Jefferies, Angus, Sharp, Helen, Jones, Hywel, Giles, Claire, Bramley, Matthew, Williams, Philip, Aldegather, Jehad, Wetherell, Simon, Lumb, William, Evans, Phil, Scouller, Frances, Macey, Neil, Rogers, Stephen, Stipp, Yvette, West, Richard, Pinney, Philip, Wadeson, Paul, Matthews, John, Pandya, Preeti, Gallagher, Andrew, Railton, T, Davies, Emyr, McClure, Jonathan, Jacobs, Marc, Hutton, Claire, Thompson, R, Sinha, Bijoy, Butter, Keith, Barrow, Susan, Little, Helen, Russell, David, Choudhary, Ulka, Haq, Ikram, Ainsworth, Paul, Jones, Claire, Weeks, Phil, Eden, Jane, Gibbons, Lisa, Glencross, Janet, MacLeod, Alison, Poland, K, Mulolland, Conor, Warke, A, Conn, Paul, Burns, D, Smith, R, Kamath, R, Webster, Jonathan, Hodgins, Ian, Vercoe, Stephen, Roome, Paul, Pinnock, Hilary, Patel, Jayesh, Ali, Amar, Hart, Nigel, Davies, Richard, De-Sousa, Nigel, Neden, Catherine, Danielsen, Mark, Sharma, Purnima, Galloway, Sophia, Hawkins, Charlotte, Oliver, Raife, Aylward, Martin, Pattni, Mira, Irvine, Gordon, Ahmad, Shahid, Rothwell, Catherine, Choudhary, Fiaz, Khalaque, Sabrina, Short, Stephanie, Peters, Sharon, Coulson, Warwick, Roberts, Neil, Butler, Amy, Coates, Steven, Ward, Ben, Jackson, Daniel, Walton, Steve, Shepherd, Diane, Wong, Toh, Boon, Mark, Deacon, Melanie, Cornelius, David, Davies, Sarah, Frankel, Ben, Hargreaves, Nick, Choi, Henry, Sumner, Jon, Myhill, Tim, Estifanos, Salah, Geatch, Diane, Wilkinson, Justin, Veale, Richard, Forshaw, Karen, Hirst, Rob, Zaman, Kashif, Liley, Catherine, Wastling, Rebecca, McEleny, Paul, Beattie, Andre, Cooke, Philip, Wong, Mike, Pugsley, Mark, Dooldeniya, Chaminda, Rogers, Greg, Bennett, James, Jacobs, Polly, Muvva, Rajesh, Adam, Matthew, Fox, Robin, Thomas, Nicolas, Cartwright, Simon, Reed, Rory, Randfield, Simon, A’Court, Christine, Flynn, Ann, Halpin, Andrew, Dobson, Simon, Lomax, Louise, Nadaph, Minnal, Munro, Iain, Goram, Jane, Stoddart, Helen, Simmons, Phil, Shewring, John, Bowen-Simpkins, Emma, Rickenbach, Mark, Blenkhorn, Adam, Singh, Bhuwanendu, Astridge, Penny, van Gaal, William, Abhayaratna, Walter, Thomson, Philip, Lehman, Ron, Kilian, Jens, Coulshed, David, Catanchin, Andrei, Colquhoun, David, Kiat, Hosen, Eccleston, David, French, John, Ayres, Bronte, Blombery, Peter, Phan, Thanh, Rogers, James, O’Donnell, David, Bae, Sang Cheol, Carroll, Patrick, Starmer, Greg, Arstall, Margaret, Binnekamp, Maurits, Lee, Astin, Luton, Robert, Gupta, Milan, Pandey, Amritanshu Shekhar, Cheung, Stephen, Leader, Rolland, Beaudry, Philippe, Ayala-Paredes, Félix, Berlingieri, Joseph, Heath, John, Poirier, Germain, du Preez, Miranda, Schweitzer, Bradley, Nadeau, Reginald, Dhillon, Ripple, Hruczkowski, Tomasz, Lavoie, Andrea, Parkash, Ratika, Cha, James, Coutu, Benoit, MacDonald, Paul, Ramjattan, Brian, Bonet, Jorge, Vizel, Saul, Angaran, Paul, Fikry, Sameh, Mowafy, Ahmed, Katta, Azza, Tawfik, Mazen, Nawar, Moustafa, Sobhy, Mohamed, Abou Seif, Seif Kamal, Khairy, Tarek, El-Aziz, Ahmed Abd, Taha, Nasser, Reda, Ashraf, Elbahry, Atef, Setiha, Mohamed, El Din, Mohamed Gamal, Elkhadem, Magdi, El-Etreby, Adel, Kettles, David, Bayat, Junaid, Siebert, Heidi, Horak, Adrian, Kelfkens, Ynez, Garda, Riaz, Pillay, Thayabran, Guerra, Michele, van Zyl, Louis, Theron, Hendrik, Murray, Andrew, Louw, Rikus, Greyling, Deon, Mntla, Pindile, Ismail, Siddique, Ahmed, Fayzal, Engelbrecht, Johannes, Maharajh, Shambu, Oosthuysen, Wessel, Loghdey, Rehana, Ueckermann, Veronica, Al Naeemi, Abdullah, Yousef, Ghazi, Bazargani, Nooshin, AlOmairi, Munther, Maruthanayagam, Rajan, Singh, Rupesh, Naguib, Ahmed, Ibrahim, Mohamed, Agrawal, Amrish, Nathani, Mukesh, Esheiba, Ehab M, Wassef, Adel, Gupta, Rajeev, Cox, Michael, Beach, Scott, Duffy, Peter, Falkowski, Stephen, Ferrick, Kevin, Franco, Miguel, Kutayli, W Michael, Quick, Annette, Sharma, Niraj, Wilson, Vance, Miller, Stephen, Alberts, Mark, Blumberg, Edwin, Canosa, Roddy, Gutowski, Ted, Ison, Rodney, Garcia, Jorge, Mullen, Paul, Noveck, Howard, Rama, Pamela, Reddy, Rajneesh, Williams, Marcus, Nishijima, Daniel, Ferdinand, Keith, Haque, Ihsan, Mendelson, Robert, Pitta, Sridevi, Theodoro, Daniel, Treasure, Charles, Moustafa, Moustafa, Cader, Cas, Pharr, Walter, Oropallo, Alisha, Platt, George, Gujral, Jaspal, Welker, James, Koura, Firas
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMJ (Clinical Research Edition)
e066450
The BMJ
BMJ-British Medical Journal
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 1756-1833
0959-8138
0959-535X
Popis: OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up. Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up. Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. CONCLUSION In this large dataset of patients with recent onset non-valvular atrial fibrillation, a small proportion were treated with cardioversion. Direct current cardioversion was performed twice as often as pharmacological cardioversion, and there appeared to be no major difference in outcome events for these two cardioversion modalities. For the overall cardioversion group, after adjustments for confounders, a significantly lower risk of mortality was found in patients who received early cardioversion compared with those who did not receive early cardioversion. STUDY REGISTRATION ClinicalTrials.gov NCT01090362.
Databáze: OpenAIRE