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Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study
Background: Atrial fibrillation (AF) increases the risk of dementia. Whether the pharmacological rhythm control of AF can reduce the risk of dementia compared to the rate control strategy remains unclear. We hypothesize that the rhythm control strategy is better than the rate control strategy in pre...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025212/ https://www.ncbi.nlm.nih.gov/pubmed/35455688 http://dx.doi.org/10.3390/jpm12040572 |
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author | Lin, Jiunn-Cherng Li, Cheng-Hung Chen, Yun-Yu Weng, Chi-Jen Chien, Yu-Shan Wu, Shang-Ju Lo, Chu-Pin Tien, Hui-Chun Lin, Ching-Heng Huang, Jin-Long Lin, Yenn-Jiang Hsieh, Yu-Cheng Chen, Shih-Ann |
author_facet | Lin, Jiunn-Cherng Li, Cheng-Hung Chen, Yun-Yu Weng, Chi-Jen Chien, Yu-Shan Wu, Shang-Ju Lo, Chu-Pin Tien, Hui-Chun Lin, Ching-Heng Huang, Jin-Long Lin, Yenn-Jiang Hsieh, Yu-Cheng Chen, Shih-Ann |
author_sort | Lin, Jiunn-Cherng |
collection | PubMed |
description | Background: Atrial fibrillation (AF) increases the risk of dementia. Whether the pharmacological rhythm control of AF can reduce the risk of dementia compared to the rate control strategy remains unclear. We hypothesize that the rhythm control strategy is better than the rate control strategy in preventing dementia. Methods: AF patients aged ≥65 years were identified from the Taiwan National Health Insurance Database. Patients receiving anti-arrhythmic drugs at a cumulative defined daily dose (cDDD) of >30 within the first year of enrollment constituted the rhythm control group. Patients who used rate control medications for a cDDD of >30 constituted the rate control group. A multivariate Cox hazards regression model was used to determine the hazard ratio (HR) for dementia. Results: A total of 3382 AF patients (698 in the rhythm control group; 2684 in the rate control group) were analyzed. During a 4.86 ± 3.38 year follow-up period, 414 dementia events occurred. The rhythm control group had a lower rate of dementia than the rate control group (adjust HR: 0.75, p = 0.031). The rhythm control strategy reduced the risk of dementia particularly in those receiving aspirin (p = 0.03). Conclusions: In patients with AF, pharmacological rhythm control was associated with a lower risk of dementia than rate control over a long-term follow-up period, particularly in patients receiving aspirin treatment. |
format | Online Article Text |
id | pubmed-9025212 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90252122022-04-23 Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study Lin, Jiunn-Cherng Li, Cheng-Hung Chen, Yun-Yu Weng, Chi-Jen Chien, Yu-Shan Wu, Shang-Ju Lo, Chu-Pin Tien, Hui-Chun Lin, Ching-Heng Huang, Jin-Long Lin, Yenn-Jiang Hsieh, Yu-Cheng Chen, Shih-Ann J Pers Med Article Background: Atrial fibrillation (AF) increases the risk of dementia. Whether the pharmacological rhythm control of AF can reduce the risk of dementia compared to the rate control strategy remains unclear. We hypothesize that the rhythm control strategy is better than the rate control strategy in preventing dementia. Methods: AF patients aged ≥65 years were identified from the Taiwan National Health Insurance Database. Patients receiving anti-arrhythmic drugs at a cumulative defined daily dose (cDDD) of >30 within the first year of enrollment constituted the rhythm control group. Patients who used rate control medications for a cDDD of >30 constituted the rate control group. A multivariate Cox hazards regression model was used to determine the hazard ratio (HR) for dementia. Results: A total of 3382 AF patients (698 in the rhythm control group; 2684 in the rate control group) were analyzed. During a 4.86 ± 3.38 year follow-up period, 414 dementia events occurred. The rhythm control group had a lower rate of dementia than the rate control group (adjust HR: 0.75, p = 0.031). The rhythm control strategy reduced the risk of dementia particularly in those receiving aspirin (p = 0.03). Conclusions: In patients with AF, pharmacological rhythm control was associated with a lower risk of dementia than rate control over a long-term follow-up period, particularly in patients receiving aspirin treatment. MDPI 2022-04-03 /pmc/articles/PMC9025212/ /pubmed/35455688 http://dx.doi.org/10.3390/jpm12040572 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lin, Jiunn-Cherng Li, Cheng-Hung Chen, Yun-Yu Weng, Chi-Jen Chien, Yu-Shan Wu, Shang-Ju Lo, Chu-Pin Tien, Hui-Chun Lin, Ching-Heng Huang, Jin-Long Lin, Yenn-Jiang Hsieh, Yu-Cheng Chen, Shih-Ann Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title | Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title_full | Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title_fullStr | Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title_full_unstemmed | Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title_short | Rhythm Control Better Prevents Dementia than Rate Control Strategies in Patients with Atrial Fibrillation—A Nationwide Cohort Study |
title_sort | rhythm control better prevents dementia than rate control strategies in patients with atrial fibrillation—a nationwide cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025212/ https://www.ncbi.nlm.nih.gov/pubmed/35455688 http://dx.doi.org/10.3390/jpm12040572 |
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