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
{"title":"Cardiovascular benefits of early rhythm control and healthy lifestyle in young atrial fibrillation.","authors":"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","doi":"10.1111/eci.70018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Aims: </strong>To evaluate the individual and synergistic benefits of ERC and HLS on MACEs in young AF patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>A total of 98,192 patients were analysed (mean age, 53.3 ± 9.0 years; 35.2% females; mean CHA<sub>2</sub>DS<sub>2</sub>-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.</p><p><strong>Conclusions: </strong>ERC and HLS were individually and synergistically associated with a significantly lower risk of MACEs in young AF patients.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70018"},"PeriodicalIF":4.4000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/eci.70018","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
