(HealthDay News) — For patients with recently diagnosed atrial fibrillation (AF) and low stroke risk, early rhythm control compared with rate control is associated with a consistently lower risk for adverse cardiovascular outcomes, according to a study published online in the Annals of Internal Medicine.
Daehoon Kim, MD, MPH, from Yonsei University College of Medicine in Seoul, South Korea, and colleagues note that rhythm control is associated with a lower risk for adverse cardiovascular outcomes compared with usual care among patients recently diagnosed with atrial fibrillation with a CHA2DS2-VASc score of approximately ≥2 in the Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET 4). The researchers examined whether these results can be generalized to patients with a low risk for stroke. The effect of early rhythm control on a primary composite outcome was compared among eligible and ineligible patients for EAST-AFNET4.
Data were included for 54,216 patients with AF with early rhythm control or rate control therapy; 69.3% were eligible for the trial (median CHA2DS2-VASc score, 4). The researchers found that among these patients, early rhythm control was associated with a reduced risk for the primary composite outcome versus rate control (hazard ratio, 0.86). For the 16,659 low-risk participants who did not meet the inclusion criteria (CHA2DS2-VASc score, 1), there was a consistent association observed for early rhythm control with a lower risk for the primary outcome (hazard ratio, 0.81).
“The beneficial association between early rhythm control (versus rate control) and cardiovascular outcomes was consistently observed in low-risk patients who did not meet the EAST-AFNET 4 eligibility criteria, as well as in the eligible patients,” the authors write.
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