Clinical factors that influence response to treatment strategies in atrial fibrillation: the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.

摘要: BACKGROUND The AFFIRM Study was a randomized multicenter comparison of 2 treatment strategies, rate-control versus rhythm-control, in high-risk patients with atrial fibrillation (AF). primary outcome the trial showed no overall difference survival between strategies. However, there may be important patient subgroups for which are identifiable differences 1 METHODS AND RESULTS Subgroups that were prespecified analysis from main age, sex, coronary artery disease (CAD), hypertension, congestive heart failure (CHF), left ventricular ejection fraction (LVEF), rhythm at randomization, first episode AF, and duration qualifying AF. Baseline characteristics analyzed each subgroup. Adjusted hazard ratios subgroup stratum generated using Cox models, these models used to determine whether strategy affected differentially by worse > or =65 years history CHF, CAD, an abnormal LVEF. In adjusted analyses, effect similar within all subgroups. When separately, without CHF had significantly better therapy (each P < .01). CONCLUSIONS Overall, rate control same certain selected categories have one particular management