Key result
Dronedarone use was associated with a significantly lower risk of cardiovascular hospitalization compared to other antiarrhythmic drugs in patients with AF/AFL (HR 0.87; 95% CI 0.79-0.96).
Why the study?
To compare the risk of cardiovascular-related hospitalizations and death in AF/AFL patients treated with dronedarone versus other antiarrhythmic drugs.
Does dronedarone reduce cardiovascular hospitalizations compared to other antiarrhythmic drugs in patients with atrial fibrillation or atrial flutter?
Cohort (n=19,047)
Does dronedarone reduce cardiovascular hospitalizations compared to other antiarrhythmic drugs in patients with atrial fibrillation or atrial flutter?
Hazard Ratio: 0.87 (95% CI 0.79–0.96)
In patients with atrial fibrillation or flutter, initiation of dronedarone is associated with a lower risk of cardiovascular hospitalizations compared to other antiarrhythmic drugs.
Dronedarone was associated with modestly lower CV hospitalization risk versus other AADs in AF/AFL; leaves open whether findings reflect benefit or residual confounding.
The antiarrhythmic drug dronedarone was designed to reduce the extra-cardiac adverse effects associated with amiodarone use in treatment of patients with atrial fibrillation / atrial flutter (AF/AFL). This epidemiological study used a retrospective cohort design to compare risk of cardiovascular-related hospitalizations and death in AF/AFL patients treated with dronedarone versus other antiarrhythmic drugs (AADs). AF/AFL patients with incident dronedarone fills were matched by propensity score (PS) to incident users of other AADs. The primary study outcome was hospitalization for cardiovascular (CV) causes within 24 months after the first study drug fill. A secondary composite outcome comprised hospitalization for CV causes or all-cause mortality during follow-up. In the AF/AFL patient cohort meeting eligibility criteria, 6,964 incident users of dronedarone and 25 607 incident users of other AADs were identified. The PS-matched cohort comprised 6,349 Dronedarone users (91.2% of all eligible) and 12,698 other AAD users. Dronedarone patients had a significantly lower risk of hospitalization for a CV event compared to Other AAD users (hazard ratio = 0.87; 95% confidence interval = 0.79 to 0.96). This was consistent with results for the composite outcome (hazard ratio=0.86; 95% confidence interval = 0.78 to 0.95). In conclusion, AF/AFL patients initiated on dronedarone versus other AADs had significantly lower risk of CV hospitalizations as well as the composite CV hospitalization / death from any cause.
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Goehring et al. (2020) conducted a cohort in Atrial fibrillation / atrial flutter (AF/AFL) (n=19,047). Dronedarone vs. Other antiarrhythmic drugs (AADs) was evaluated on Hospitalization for cardiovascular (CV) causes within 24 months after the first study drug fill (HR 0.87, 95% CI 0.79 to 0.96). Dronedarone use was associated with a significantly lower risk of cardiovascular hospitalization compared to other antiarrhythmic drugs in patients with AF/AFL (HR 0.87; 95% CI 0.79-0.96).