Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of the American College of Cardiology, 80(4), 283–295. https://doi.org/10.1016/j.jacc.2022.04.058 Dr. Andreas Goette et al
Points
- In this study, patients have grouped into three groups: In the first group, patients with FDAF these patients were enrolled seven days after diagnosis of AF, the second group of patients with paroxAF had a duration of < 12 months; and the third group of patients was with persAF with the duration of < 12months.
- These results concluded reduced stroke, cardiovascular deaths, and heart failure hospitalizations with ERC regardless of AF pattern. During follow-up, FDAF patients were at a higher risk of ACS and hospitalization, especially those treated with ERC. Less improvement was observed in FDAF patients compared to the pattern of AF of two others.
Summary
This study was planned to collate clinical parameters and consequences in patients with different patterns of atrial fibrillation (AF) on early rhythm control (ERC) compared with routine care.
Effects of ERC were compared in paroxysmal atrial fibrillation (paroxAF) patients 994 in numbers, first diagnosed AF (FDAF) patients were 1048 in numbers, and persistent AF (persAF) patients were 743 in numbers, in EAST-AFNET 4 (for prevention of stroke, early treatment of atrial fibrillation) trials. Patterns of AF were compared with first primary outcomes (stroke, cardiovascular death, acute coronary syndrome, and heart failure hospitalization) and second primary outcomes (how many nights spent in hospital annually) over 5.1y mean follow-up. EQ-5D was used to access health-related changes in quality of life.
In FDAF, more patients were hospitalized for acute coronary syndrome compared to paroxAF and persAF. Night stay in hospital was more for FDAF patients than paroxAF and persAF patients. EQ-5D (health-related quality of life) score was improved in patients with ERC who have paroxAF and persAF, but this improvement was not observed in FDAF.
Finally, concluded that in all pattrens of AF, reduced heart-related complications (stroke, death of myocardium, hospitalization due to heart failure). FDAF may act as a simple biomarker for the identification of ACS patients.
Link to the article: https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.04.058
References Goette, A., Borof, K., Breithardt, G., Camm, A. J., Crijns, H. J. G. M., Kuck, K.-H., Wegscheider, K., Kirchhof, P. (2022). Presenting pattern of atrial fibrillation and outcomes of early rhythm control therapy. Journal of the American College of Cardiology, 80(4), 283–295. https://doi.org/10.1016/j.jacc.2022.04.058
