Marisa R DeLuca, Bilal Ali, Yasir Tarabichi, Beni R Verma, Saima Karim
{"title":"射血分数保留型心力衰竭患者心房颤动的导管消融与抗心律失常疗法的对比","authors":"Marisa R DeLuca, Bilal Ali, Yasir Tarabichi, Beni R Verma, Saima Karim","doi":"10.1016/j.hrthm.2024.10.034","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Clinical outcomes of patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) treated with catheter ablation (CA) vs antiarrhythmic therapy (AAT) are not well known.</p><p><strong>Objective: </strong>This study compared morbidity and mortality of patients with AF and HFpEF treated with CA vs AAT.</p><p><strong>Methods: </strong>AF and HFpEF patients from January 2017 to June 2023 were identified in TriNetX, a large global population-based database. Patients with prior diagnosis of heart failure with reduced ejection fraction (HFrEF) or crossover between AAT and CA were excluded. Baseline characteristics including age, sex, body mass index, type of AF, comorbidities, and cardiovascular medications were compared. The 2 groups were 1:1 propensity score matched for outcomes analysis. All-cause mortality, cerebrovascular accident/transient ischemic attack, and acute heart failure were compared with Kaplan-Meier curves.</p><p><strong>Results: </strong>Patients treated with CA (n = 1959) and AAT (n = 7689) were 1:1 propensity score matched, yielding 3632 patients with no significant differences in baseline characteristics. Compared with AAT, CA was associated with decreased mortality (9.2% vs 20.5%; hazard ratio [HR], 0.431; 95% confidence interval [CI], 0.359-0.518; P < .001). In addition, CA was associated with reduced HFpEF (HR, 0.638; 95% CI, 0.550-0.741; P < .001) and acute HFrEF (HR, 0.645; 95% CI, 0.452-0.920; P = .015). There was no difference in composite of cerebrovascular accident/transient ischemic attack (HR, 0.935; 95% CI, 0.725-1.207; P = .607).</p><p><strong>Conclusion: </strong>In this retrospective study of patients with AF and HFpEF, CA was associated with lower mortality and risk of acute heart failure compared with AAT.</p>","PeriodicalId":5,"journal":{"name":"ACS Applied Materials & Interfaces","volume":null,"pages":null},"PeriodicalIF":8.3000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction.\",\"authors\":\"Marisa R DeLuca, Bilal Ali, Yasir Tarabichi, Beni R Verma, Saima Karim\",\"doi\":\"10.1016/j.hrthm.2024.10.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Clinical outcomes of patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) treated with catheter ablation (CA) vs antiarrhythmic therapy (AAT) are not well known.</p><p><strong>Objective: </strong>This study compared morbidity and mortality of patients with AF and HFpEF treated with CA vs AAT.</p><p><strong>Methods: </strong>AF and HFpEF patients from January 2017 to June 2023 were identified in TriNetX, a large global population-based database. Patients with prior diagnosis of heart failure with reduced ejection fraction (HFrEF) or crossover between AAT and CA were excluded. Baseline characteristics including age, sex, body mass index, type of AF, comorbidities, and cardiovascular medications were compared. The 2 groups were 1:1 propensity score matched for outcomes analysis. All-cause mortality, cerebrovascular accident/transient ischemic attack, and acute heart failure were compared with Kaplan-Meier curves.</p><p><strong>Results: </strong>Patients treated with CA (n = 1959) and AAT (n = 7689) were 1:1 propensity score matched, yielding 3632 patients with no significant differences in baseline characteristics. Compared with AAT, CA was associated with decreased mortality (9.2% vs 20.5%; hazard ratio [HR], 0.431; 95% confidence interval [CI], 0.359-0.518; P < .001). In addition, CA was associated with reduced HFpEF (HR, 0.638; 95% CI, 0.550-0.741; P < .001) and acute HFrEF (HR, 0.645; 95% CI, 0.452-0.920; P = .015). There was no difference in composite of cerebrovascular accident/transient ischemic attack (HR, 0.935; 95% CI, 0.725-1.207; P = .607).</p><p><strong>Conclusion: </strong>In this retrospective study of patients with AF and HFpEF, CA was associated with lower mortality and risk of acute heart failure compared with AAT.</p>\",\"PeriodicalId\":5,\"journal\":{\"name\":\"ACS Applied Materials & Interfaces\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":8.3000,\"publicationDate\":\"2024-10-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Materials & Interfaces\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hrthm.2024.10.034\",\"RegionNum\":2,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MATERIALS SCIENCE, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Materials & Interfaces","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.10.034","RegionNum":2,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MATERIALS SCIENCE, MULTIDISCIPLINARY","Score":null,"Total":0}
Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction.
Background: Clinical outcomes of patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) treated with catheter ablation (CA) vs antiarrhythmic therapy (AAT) are not well known.
Objective: This study compared morbidity and mortality of patients with AF and HFpEF treated with CA vs AAT.
Methods: AF and HFpEF patients from January 2017 to June 2023 were identified in TriNetX, a large global population-based database. Patients with prior diagnosis of heart failure with reduced ejection fraction (HFrEF) or crossover between AAT and CA were excluded. Baseline characteristics including age, sex, body mass index, type of AF, comorbidities, and cardiovascular medications were compared. The 2 groups were 1:1 propensity score matched for outcomes analysis. All-cause mortality, cerebrovascular accident/transient ischemic attack, and acute heart failure were compared with Kaplan-Meier curves.
Results: Patients treated with CA (n = 1959) and AAT (n = 7689) were 1:1 propensity score matched, yielding 3632 patients with no significant differences in baseline characteristics. Compared with AAT, CA was associated with decreased mortality (9.2% vs 20.5%; hazard ratio [HR], 0.431; 95% confidence interval [CI], 0.359-0.518; P < .001). In addition, CA was associated with reduced HFpEF (HR, 0.638; 95% CI, 0.550-0.741; P < .001) and acute HFrEF (HR, 0.645; 95% CI, 0.452-0.920; P = .015). There was no difference in composite of cerebrovascular accident/transient ischemic attack (HR, 0.935; 95% CI, 0.725-1.207; P = .607).
Conclusion: In this retrospective study of patients with AF and HFpEF, CA was associated with lower mortality and risk of acute heart failure compared with AAT.
期刊介绍：
ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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