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Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation

Background: This study aimed to investigate the associations between sex and the relative effect of rhythm control over rate control in patients with atrial fibrillation. Methods: We used the National Health Insurance Service database to select patients treated for atrial fibrillation within one yea...

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Autores principales: Kang, Dong-Seon, Kim, Daehoon, Jang, Eunsun, Yu, Hee Tae, Kim, Tae-Hoon, Pak, Hui-Nam, Sung, Jung-Hoon, Lee, Moon-Hyoung, Yang, Pil-Sung, Joung, Boyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456685/
https://www.ncbi.nlm.nih.gov/pubmed/36078919
http://dx.doi.org/10.3390/jcm11174991
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author Kang, Dong-Seon
Kim, Daehoon
Jang, Eunsun
Yu, Hee Tae
Kim, Tae-Hoon
Pak, Hui-Nam
Sung, Jung-Hoon
Lee, Moon-Hyoung
Yang, Pil-Sung
Joung, Boyoung
author_facet Kang, Dong-Seon
Kim, Daehoon
Jang, Eunsun
Yu, Hee Tae
Kim, Tae-Hoon
Pak, Hui-Nam
Sung, Jung-Hoon
Lee, Moon-Hyoung
Yang, Pil-Sung
Joung, Boyoung
author_sort Kang, Dong-Seon
collection PubMed
description Background: This study aimed to investigate the associations between sex and the relative effect of rhythm control over rate control in patients with atrial fibrillation. Methods: We used the National Health Insurance Service database to select patients treated for atrial fibrillation within one year after diagnosis. The primary composite outcome comprised cardiovascular death, ischemic stroke, heart failure hospitalization, or acute myocardial infarction. Results: During the mean follow-up (4.9 ± 3.2 years), the benefit of rhythm control over rate control on the primary composite outcome became statistically insignificant after 3 months from atrial fibrillation diagnosis in women while remained steadily until 12 months in men. The risk of primary composite outcome for rhythm control was lower than that for rate control in both sexes if it was initiated within 6 months (men: HR = 0.86, 95%CI = 0.79–0.94; women: HR = 0.85, 95%CI = 0.78–0.93; P for interaction = 0.844). However, there was significant interaction between sex and the relative effect of rhythm control if it was initiated after 6 months (men: HR = 0.72, 95%CI = 0.52–0.99; women: HR = 1.32, 95%CI = 0.92–1.88; P for interaction = 0.018). Conclusion: Rhythm control resulted in lower risk of primary composite outcome than rate control in both sexes; however, the treatment initiation at an earlier stage might be considered in women.
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spelling pubmed-94566852022-09-09 Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation Kang, Dong-Seon Kim, Daehoon Jang, Eunsun Yu, Hee Tae Kim, Tae-Hoon Pak, Hui-Nam Sung, Jung-Hoon Lee, Moon-Hyoung Yang, Pil-Sung Joung, Boyoung J Clin Med Article Background: This study aimed to investigate the associations between sex and the relative effect of rhythm control over rate control in patients with atrial fibrillation. Methods: We used the National Health Insurance Service database to select patients treated for atrial fibrillation within one year after diagnosis. The primary composite outcome comprised cardiovascular death, ischemic stroke, heart failure hospitalization, or acute myocardial infarction. Results: During the mean follow-up (4.9 ± 3.2 years), the benefit of rhythm control over rate control on the primary composite outcome became statistically insignificant after 3 months from atrial fibrillation diagnosis in women while remained steadily until 12 months in men. The risk of primary composite outcome for rhythm control was lower than that for rate control in both sexes if it was initiated within 6 months (men: HR = 0.86, 95%CI = 0.79–0.94; women: HR = 0.85, 95%CI = 0.78–0.93; P for interaction = 0.844). However, there was significant interaction between sex and the relative effect of rhythm control if it was initiated after 6 months (men: HR = 0.72, 95%CI = 0.52–0.99; women: HR = 1.32, 95%CI = 0.92–1.88; P for interaction = 0.018). Conclusion: Rhythm control resulted in lower risk of primary composite outcome than rate control in both sexes; however, the treatment initiation at an earlier stage might be considered in women. MDPI 2022-08-25 /pmc/articles/PMC9456685/ /pubmed/36078919 http://dx.doi.org/10.3390/jcm11174991 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
Kang, Dong-Seon
Kim, Daehoon
Jang, Eunsun
Yu, Hee Tae
Kim, Tae-Hoon
Pak, Hui-Nam
Sung, Jung-Hoon
Lee, Moon-Hyoung
Yang, Pil-Sung
Joung, Boyoung
Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title_full Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title_fullStr Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title_full_unstemmed Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title_short Sex Difference in Effectiveness of Early Rhythm- over Rate-Control in Patients with Atrial Fibrillation
title_sort sex difference in effectiveness of early rhythm- over rate-control in patients with atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456685/
https://www.ncbi.nlm.nih.gov/pubmed/36078919
http://dx.doi.org/10.3390/jcm11174991
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