Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation
- 주제(키워드) Atrial fibrillation , Rhythm , Rate , Stroke
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kim, Jae Guk] Eulji Univ Hosp, Dept Neurol, Daejeon, South Korea; [Lee, Young Soo] Daegu Catholic Univ, Dept Internal Med, Div Cardiol, Med Ctr, Daegu, South Korea; [Kang, Ki-Woon] Eulji Univ Hosp, Dept Internal Med, Div Cardiol, 95 Dunsanseo Ro, Daejeon 35233, South Korea; [Choi, Eue-Keun; Cha, Myung-Jin] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Lee, Jung-Myung; Kim, Jin-Bae] Kyung Hee Univ Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea; [Park, Junbeom] Ewha Womans Univ, Dept Cardiol, Sch Med, Seoul, South Korea; [Park, Jin-Kyu] Hanyang Univ, Dept Cardiol, Seoul Hosp, Seoul, South Korea; [Kim, Tae-Hoon; Uhm, Jae-Sun; Joung, Boyoung] Yonsei Univ, Severance Cardiovasc Hosp, Dept Internal Med, Div Cardiol,Coll Med, Seoul, South Korea; [Shim, Jaemin] Korea Univ, Dept Internal Med, Div Cardiol, Med Ctr, Seoul, South Korea; [Kim, Jun] Univ Ulsan, Asan Med Ctr, Heart Inst, Coll Med, Seoul, South Korea; [Park, HyungWook] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Dept Cardiol, Sch Med, Gwangju, South Korea; [Kim, Changsoo] Yonsei Univ, Dept Prevent Med, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 gold, Green Published
- 발행기관 KOREAN ASSOC INTERNAL MEDICINE
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175416
- 본문언어 영어
- Published As http://dx.doi.org/10.3904/kjim.2019.063
- PubMed https://pubmed.ncbi.nlm.nih.gov/31597907
초록/요약
Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control strategy is associated with a lower risk of ischemic stroke compared to the rate control strategy in NVAF patients. Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive patients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 NVAF patients (age, 67 +/- 10 years; male, 61.8%) were clinically followed up for over 1-year and divided into rate and rhythm control groups. Results: Those treated with the rhythm control strategy were younger and had less proportions of underlying disease compared to those treated with the rate control strategy. After the propensity matching analysis, those treated with the rhythm control strategy had similar baseline characteristics including the CHA2DS2-VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also similarly between the two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than in the rate control group (0.7 vs. 6.9 per 1,000 person-years, p = 0.011). Conclusions: The rhythm control strategy demonstrated a beneficial effect to lower the risk of ischemic stroke during a 1-year follow-up compared to the rate control strategy.
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