The Association Between the Use of Antiarrhythmic Drugs in Non-Valvular Atrial Fibrillation and Patient Prognosis Using Data from the China Atrial Fibrillation (China-AF) Registry
机构:[1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing Anzhen Hosp, Dept Cardiol, Beijing, Peoples R China首都医科大学附属安贞医院[2]Capital Med Univ, Beijing Tongren Hosp, Ctr Cardiovasc, Beijing, Peoples R China首都医科大学附属北京同仁医院首都医科大学附属同仁医院[3]Univ New South Wales, Ctr Big Data Res Hlth, Sydney, NSW, Australia[4]Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia[5]China Food & Drug Adm, Ctr Drug Evaluat, Beijing, Peoples R China[6]Zhengzhou Univ, Dept Cardiol, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China
Background: Results of the landmark Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial comparing rhythm control and rate control strategies has led to dramatic changes in the pharmacological management of non-valvular atrial fibrillation (NVAF) patients. We sought to investigate the effect of antiarrhythmic drugs (AADs) on the clinical outcomes of NVAF patients using "real-world" data from China. Material/Methods: We evaluated the association between AAD usage and clinical outcomes using clinical data of 8161 NVAF patients who were AAD-naive before enrollment in the China Atrial Fibrillation Registry, recruited between August 2011 and February 2017. The primary outcome was all-cause mortality. Results: Compared with 6167 patients who never used any AADs, 1994 patients in the AAD group had lower incidence (per 100 person-years) of all-cause mortality (1.44 versus 3.91), cardiovascular death (0.45 versus 2.31), ischemic stroke (1.36 versus 2.03), and cardiovascular hospitalization (9.83 versus 10.22) over a mean follow-up duration of 316.7 +/- 90.4 days. After adjusting for potential confounders, AAD usage was associated with a lower risk of all-cause mortality [hazard ratio (HR): 0.50, 95% confidence interval (CI): 0.31-0.81] and decreased risk of cardiovascular death (HR: 0.30, 95% CI: 0.13-0.68). Subgroup analysis revealed AAD was associated with higher risk of cardiovascular hospitalization among female patients. Conclusions: AAD usage was associated with lower risk of 1-year all-cause mortality and cardiovascular death in "real-world" patients with NVAF.
基金:
National Key R&D Program of China [2016YFC1301002, 2016YFC0900901, 2017YFC0908803, 2018YFC1312501]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81530016]; Beijing Municipal Commission of Science and Technology [D151100002215003, D151100002215004]; Bristol-Myers Squibb (BMS)Bristol-Myers Squibb; PfizerPfizer; Johnson JohnsonJohnson & JohnsonJohnson & Johnson USA; Boehringer-Ingelheim (BI)Boehringer Ingelheim; BayerBayer AG
第一作者机构:[1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing Anzhen Hosp, Dept Cardiol, Beijing, Peoples R China[2]Capital Med Univ, Beijing Tongren Hosp, Ctr Cardiovasc, Beijing, Peoples R China
通讯作者:
通讯机构:[1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing Anzhen Hosp, Dept Cardiol, Beijing, Peoples R China[6]Zhengzhou Univ, Dept Cardiol, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China
推荐引用方式(GB/T 7714):
Hou Xiao-Xia,Du Xin,Zheng Danni,et al.The Association Between the Use of Antiarrhythmic Drugs in Non-Valvular Atrial Fibrillation and Patient Prognosis Using Data from the China Atrial Fibrillation (China-AF) Registry[J].MEDICAL SCIENCE MONITOR.2019,25:4856-4868.doi:10.12659/MSM.916855.
APA:
Hou, Xiao-Xia,Du, Xin,Zheng, Danni,Li, Yan-Ming,He, Liu...&Dong, Jian-Zeng.(2019).The Association Between the Use of Antiarrhythmic Drugs in Non-Valvular Atrial Fibrillation and Patient Prognosis Using Data from the China Atrial Fibrillation (China-AF) Registry.MEDICAL SCIENCE MONITOR,25,
MLA:
Hou, Xiao-Xia,et al."The Association Between the Use of Antiarrhythmic Drugs in Non-Valvular Atrial Fibrillation and Patient Prognosis Using Data from the China Atrial Fibrillation (China-AF) Registry".MEDICAL SCIENCE MONITOR 25.(2019):4856-4868