Early Rhythm Control Strategy in Early Atrial Fibrillation Patients.

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
International heart journal Pub Date : 2024-11-30 Epub Date: 2024-11-14 DOI:10.1536/ihj.24-137
Yiwei Liu, Xiaowei Chen, Hongbo Lin, Peng Shen, Feng Sun, Yang Xu
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引用次数: 0

Abstract

Atrial fibrillation (AF) pharmaceutical treatment strategy on when to start rhythm control has been debated for decades. In early studies, these 2 strategies exhibited equivalent efficacy; however, more recent studies based on CHA2DS2-VASc score indicated that early rhythm control (ERC) is more beneficial than UC. We hypothesized that ERC might benefit persons with AF in other cardiovascular outcomes, regardless of the CHA2DS2-VASc score. To elucidate this, we conducted the present study.A retrospective cohort study was conducted using the Yinzhou Regional Health Care Database. We included all patients diagnosed with AF within 1 year and excluded those without age/sex information, without ERC/UC treatment prescription, or with ongoing cancer. The primary outcome was major cardiovascular events (MACE). We used inverse probability of treatment weighting (IPTW) for covariate weighting.A total of 7,161 patients diagnosed with early-stage AF were included in this study. Of them, 2,248 and 4,913 were included in the ERC and UC groups, respectively. During the mean follow-up period of 3.2 years (27,945 person-year), and after IPTW, ERC showed significantly lower risk for MACE (HR: 0.75 [0.61, 0.96], P = 0.02) and heart failure (HF; HR: 0.71 [0.54, 0.95], P = 0.01). No significant results were obtained for stroke, cardiovascular death, or all-cause mortality.ERC is more beneficial to early-stage Persons with AF than UC for MACEs, particularly HF.

早期心房颤动患者的早期节律控制策略
几十年来,关于何时开始控制心律的房颤药物治疗策略一直备受争议。在早期研究中,这两种策略表现出同等疗效;但最近基于 CHA2DS2-VASc 评分的研究表明,早期节律控制(ERC)比 UC 更有益。我们假设,无论 CHA2DS2-VASc 评分如何,ERC 都可能使房颤患者在其他心血管结果方面受益。我们利用鄞州地区医疗数据库开展了一项回顾性队列研究。我们纳入了所有在 1 年内确诊为房颤的患者,并排除了无年龄/性别信息、无 ERC/UC 治疗处方或患有癌症的患者。主要结果是主要心血管事件(MACE)。本研究共纳入了 7161 名早期房颤患者。本研究共纳入 7,161 名确诊为早期房颤的患者,其中 2,248 人被纳入 ERC 组,4,913 人被纳入 UC 组。在平均 3.2 年(27,945 人-年)的随访期间和 IPTW 之后,ERC 显示出显著较低的 MACE(HR:0.75 [0.61, 0.96],P = 0.02)和心力衰竭(HF;HR:0.71 [0.54, 0.95],P = 0.01)风险。在卒中、心血管死亡或全因死亡率方面没有明显结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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