Early rhythm control significantly reduced the risk of major cardiovascular events (HR 0.75) compared to usual care in patients with early atrial fibrillation.
Cohort (n=7,161)
Yes
Does early rhythm control reduce major cardiovascular events in patients with early atrial fibrillation compared to usual care?
Early rhythm control in patients with early atrial fibrillation is associated with a significantly lower risk of major cardiovascular events, particularly heart failure, compared to usual rate control.
Effect estimate: HR 0.75 (95% CI 0.61-0.96)
Absolute Event Rate: 14% vs 22%
p-value: p=0.02
Abstract Introduction : Atrial fibrillation (AF) treatment strategy on whether to use rhythm control or usual care (UC) has been debated for decades. In early studies, these two strategies showed equivalent efficacy, but more recent studies based on CHA 2 DS 2 -VASc score indicated that early rhythm control (ERC) would benefit more than UC strategy. We hypothesized that ERC might benefit AF patients in other cardiovascular outcomes, regardless of CHA 2 DS 2 -VASc score. To clarify this, we conducted the current study. Methods : A retrospective cohort study was carried out using the Yinzhou Regional Health Care Database (YRHCD). We included all patients diagnosed with AF within 1 year, while excluding those without age/sex information, no 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 covariates weighting. Results : In total, 7,161 patients diagnosed with early AF were included in this study, 2,248 and 4,913 were in ERC group and usual care group, respectively. During mean follow-up period 3.2 years (27,945 person-year), and after IPTW, the result remained similar for ERC showed significantly lower risk for MACE (HR: 0.750.61, 0.96, P =0.02), and heart failure (HR: 0.710.54,0.95, P =0.01). No significant results were found in stroke, cardiovascular death, or all-cause mortality. Conclusion : Early rhythm control is more beneficial to early AF patients than usual care for major cardiovascular events.
Liu et al. (Mon,) conducted a cohort in Early atrial fibrillation (n=7,161). Early rhythm control vs. Usual care (rate control) was evaluated on Major cardiovascular events (MACE) (HR 0.75, 95% CI 0.61-0.96, p=0.02). Early rhythm control significantly reduced the risk of major cardiovascular events (HR 0.75) compared to usual care in patients with early atrial fibrillation.