Cardiovascular benefits of early rhythm control and healthy lifestyle in young atrial fibrillation

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2025-03-07 DOI:10.1111/eci.70018

Kyung-Yeon Lee, So-Ryoung Lee, Eue-Keun Choi, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip

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引用次数: 0

Abstract

Background

Limited evidence exists regarding the consistent and synergistic benefits of early rhythm control (ERC) and healthy lifestyle (HLS) on major adverse cardiovascular events (MACEs) in young patients with atrial fibrillation (AF).

Aims

To evaluate the individual and synergistic benefits of ERC and HLS on MACEs in young AF patients.

Methods

In an observational cohort study using a Korean nationwide claims database, new-onset AF patients (age 20–<65 years) were included. ERC was defined as rhythm control treatment within 2 years of AF diagnosis, and HLS as having at least two healthy lifestyle behaviours (quitting smoking/abstaining from alcohol/regular exercise). Patients were grouped into: without ERC and HLS (n = 28,809); HLS alone (n = 41,827); ERC alone (n = 10,962); and both ERC and HLS (n = 16,594). The primary outcome was MACEs, and the secondary outcomes included ischaemic stroke, myocardial infarction, heart failure hospitalisation and all-cause death. Multivariable Cox regression analysis assessed HR for MACEs.

Results

A total of 98,192 patients were analysed (mean age, 53.3 ± 9.0 years; 35.2% females; mean CHA₂DS₂-VASc score, 1.6 ± 1.3). The ERC and HLS groups were significantly associated with a lower risk of MACEs (ERC: HR .765; 95% CI .722–.810, p < .001 and HLS: HR .813, 95% CI .770–.860, p < .001) compared to those without ERC and HLS; both the ERC and HLS groups were associated with the lowest risk of MACEs (HR .616, 95% CI .569–.666, p < .001). Similar trends were observed for ischaemic stroke among secondary outcomes.

Conclusions

ERC and HLS were individually and synergistically associated with a significantly lower risk of MACEs in young AF patients.

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早期心律控制和健康生活方式对年轻房颤的心血管益处

背景：关于早期心律控制（ERC）和健康生活方式（HLS）对年轻心房颤动（AF）患者主要不良心血管事件（mace）的一致性和协同效益的证据有限。目的：评估ERC和HLS对年轻房颤患者mace的个体和协同效益。方法：在一项使用韩国全国索赔数据库的观察性队列研究中，新发房颤患者（年龄20岁）。结果：共分析了98,192例患者(平均年龄53.3±9.0岁；35.2%的女性;平均CHA2DS2-VASc评分，1.6±1.3)。ERC组和HLS组与较低的mace风险显著相关(ERC: HR .765；95% ci .722。结论：ERC和HLS与年轻房颤患者发生mace的风险显著降低单独或协同相关。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.