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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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