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1. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

Author

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Roura-Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong ASL, Kala P, Diez Gil JL, Carrillo X, Dirksen MT, Becerra-Muñoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld AO, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac A, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martìnez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Fores J, Vignali L, Pereira H, Manzo-Silberman S, Ordonez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Ylitalo A, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe C, Kanakakis J, Faurie B, Gabrielli G, Gutiérrez A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito A, Saint-Joy V, Pessah G, Tuccillo B, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, Verdoia M, ISACS-STEMI COVID-19, Collaborators, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L. O., Loh, P. H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong, A. S. L., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M. T., Becerra-Munoz, V. M., Kang-Yin Lee, M., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A. O., Galasso, G., Lux, A., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Lozano Martinez-Luengas, I., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Sanchis Fores, J., Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Ozkan, A. A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Brum Silveira, J. A., Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez, A., Bachini, J. P., Rocha, A., Tam, F. C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M. A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Subjects
Registrie, Male, ST Elevation Myocardial Infarction/diagnosis, Time Factors, Percutaneous, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Coronary Artery Disease, Practice Patterns, 030204 cardiovascular system & hematology, Rate ratio, Time-to-Treatment/trends, Cardiologists, 0302 clinical medicine, Retrospective Studie, Heart Rate, Risk Factors, Pandemic, ST segment, Registries, Hospital Mortality, 030212 general & internal medicine, Myocardial infarction, Practice Patterns, Physicians', 10. No inequality, Percutaneous Coronary Intervention/adverse effects, Hospital Mortality/trends, COVID-19, myocardial infarction, percutaneous coronary intervention, Incidence, Incidence (epidemiology), Middle Aged, 3. Good health, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, Cardiologists/trends, Human, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, Risk Assessment, ST Elevation Myocardial Infarction, Time-to-Treatment, medicine.medical_specialty, Time Factor, Coronavirus disease 2019 (COVID-19), Cardiologist, 03 medical and health sciences, Internal medicine, medicine, Acute Coronary Syndrome, Pandemics, Physicians', SARS-CoV-2, business.industry, Risk Factor, COVID-19, myocardial infarction, percutaneous coronary intervention, Percutaneous coronary intervention, medicine.disease, Practice Patterns, Physicians'/trends, business
Abstract

ObjectiveThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).MethodsThis is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.ResultsIn 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (pConclusionPercutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.Trial registration numberNCT04412655.

Published
2022

2. Radi Macruz – The Legacy of an Icon

Author

Edmar Atik, Charles Mady, and José Antonio Franchini Ramires

Subjects
Ethics, Médicos, business.industry, Cardiology, Ética Médica, Arginine, Faculty, Docentes, Cardiologia, Editorial, Cardiologistas/tendências, Physicians, Medical, RC666-701, Humans, Diseases of the circulatory (Cardiovascular) system, Medicine, Cardiology and Cardiovascular Medicine, business, Cardiologists/trends, Humanities, Radi Macruz
Abstract

Radi Macruz, Professor-associado do Departamento de Cardiopneumologia da Faculdade de Medicina da Universidade de Sao Paulo, faleceu em Sao Paulo em 30 de novembro de 2020, aos 95 anos. Nasceu em 5 de julho de 1925 em Sao Paulo, filho dos libaneses Kalil e Nini Macruz, tornou-se, apos formacao academica de Medicina na FMUSP, o grande medico e pioneiro de muitos avancos que o caracterizaram como um dos icones de maior relevância. Era um idealizador, na perseguicao da dinâmica mais [...]

Published
2021

3. Contemporary Presentation and Management of Valvular Heart Disease The EURObservational Research Programme Valvular Heart Disease II Survey

Author

Iung, B., Delgado, V., Rosenhek, R., Price, S., Prendergast, B., Wendler, O., Bonis, M. de, Tribouilloy, C., Evangelista, A., Bogachev-Prokophiev, A., Apor, A., Ince, H., Laroche, C., Popescu, B.A., Pierard, L., Haude, M., Hindricks, G., Ruschitzka, F., Windecker, S., Bax, J.J., Maggioni, A., Vahanian, A., Mekhaldi, S., Lemaitre, K., Authier, S., Druais, H., Goda, A., Mascherbauer, J., Samadov, F., Pasquet, A., Linhartova, K., Ihlemann, N., Abdelhamid, M., Saraste, A., Kostovska, E.S., Bajraktari, G., Mirrakhimov, E., Erglis, A., Mizariene, V., Cassar, D., Tomkiewicz-Pajak, L., Ribeiras, R., Popescu, B., Beleslin, B., Simkova, I., Dogan, S.M., Rahman-Haley, S., Shirka, E., Dado, E., Zera, E., Bica, L., Heger, M., Muslumova, F., Jahangirov, T., Ahmedov, T., Husseynov, S., Cosyns, B., Camp, G. van, Sindelarova, S., Branny, M., Parenicova, I., Vondrackova, D.J., Homza, M., Ostransky, J., Hasan-Ali, H., Abdelhady, Y., Hassan, M., Soliman, H., Mostafa, A.E., Moaaz, M., Kazamel, G., Sadek, Y., Eltobgi, S., Kamal, D., Kylmala, M., Turpeinen, A., Monin, J.L., Jobic, Y., Attias, D., Magne, J., Marechaux, S., Donal, E., Biere, L., Bernard, A., Daudin, M., Khounlaboud, M., Habib, G., Bardet, H., Audonnet, M., Thuny, F., Plurien, F., Berenfeld, A., Gervais, R., Sorbets, E., Charbonnier, A., Bauer, F., Menager-Gangloff, C., Gjerakorska-Radovikj, M., Jordanova, S., Caglayan, E., Hambrecht, R., Akin, I., Maier, L., Nickenig, G., Scholtz, W., Schulze, P.C., Heintzen, M., Er, F., Sigusch, H., Spargias, K., Kamperidis, V., Sachpekidis, V., Bellos, V., Kanakakis, I., Papafaklis, M., Makris, A., Poulimenos, L., Katsaros, A., Lampropoulos, K., Bartha, E., Zsary, A., Jebelovszki, E., Cziraki, A., Borsanyi, T., Lupkovics, G., Jarai, Z., Ibrahimi, P., Arapova, R., Laahunova, E., Sime, I., Rancane, G., Radauskaite, G., Raugaliene, R., Xuereb, R.G., Djaberi, R., Komar, M., Szymanski, P., Zaborska, B., Mizia-Stec, K., Regulski, M., Bogacki, P., Sedziwy, E., Komor, K., Myszor, J., Joao, I., Martins, R., Cabral, S., Gago, P., Cardoso, G., Almeida, I., Antunes, N., Carvalho, S., Galrinho, A., Freitas, A., Grigorica, L., Mitre, A., Ionac, A., Tint, D., Popescu, A., Petris, A.O., Onut, R., Pop, C., Usurelu, C., Beyer, R., Militaru, C., Eminovici, G., Arsenescu-Georgescu, C., Irtyuga, O., Semenova, E., Boldyrev, S., Kozmin, D., Gross, Y., Zotov, A., Kuznetsov, D., Nemchenko, E., Kulumbegov, O., Jakubov, R., Stefanov, S., Schneider, Y., Tsechanovich, V., Gamzaev, A., Fomenko, M., Mayorova, O., Skripkina, E., Safina, V., Slastin, Y., Koroleva, T., Polyaeva, L., Tarasenko, I., Alekseeva, S., Magamet, V., Medvedev, I., Khilova, L., Verevetinov, A., Stojsic-Milosavljevic, A., Nikolic, N.M., Ostric, D.K., Ruzicic, D., Pavlovic, S., Milosavljevic, J., Jovovic, L., Margoczy, R., Valocik, G., Studencan, M., Iglesias, F.C., Mendez, I., Gomez, A.G., Sanchez Fernandez, P.L., Valenzuela, G.M., Cladellas, M., Villegas, D.V., Moral, S., Gallego, I.M., Paya, R., Caballero, L., Paton, R.R., Esteban, E., Iglesia-Carreno, C., Alberca, M.T., Valle, A., Molina-Mora, M.J., Castro, N., Sayar, N., Demirtas, A.O., Yesilay, A., Demir, S., Bozkurt, A., Kanar, B., Gudul, N.E., Yildirim, T., Taylan, G., Mert, K.U., Yilmaztepe, M.A., Mert, G.O., Cosansu, K., Sayin, M.R., Karabag, T., EORP VHD II Investigators, Instituto Universitario de Investigacion de Nanocienca de Aragon, University of Zaragoza - Universidad de Zaragoza [Zaragoza], Instituto de Física de Cantabria (IFCA), Universidad de Cantabria [Santander]-Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), Leibniz Institute for Astrophysics Potsdam (AIP), St. Josef Hospital, Ruhr-University Bochum, Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM), Leiden University Medical Center (LUMC), Universiteit Leiden, Medizinische Universität Wien = Medical University of Vienna, Department of Imaging Royal Brompton Hospital, Royal Brompton Hospital, Guy's and St Thomas' Hospital [London], CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Vall d'Hebron University Hospital [Barcelona], Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Liège (CHU-Liège), Lukaskrankenhaus, Universität Leipzig, University Heart Centre Freiburg - Bad Krozingen, Research Center [Associazione Nazionale Medici Cardiologi Ospedalieri] (ANMCO Research Center), Associazione Nazionale Medici Cardiologi Ospedalieri [Firenze] (ANMCO), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Uppsala University, SAFRAN Group, Laboratory of In Vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel (VUB), Université de Lille, Sciences et Technologies, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes - Faculté de Médecine (UR Médecine), Université de Rennes (UR), CHU Pontchaillou [Rennes], Laboratoire de Protection et Remodelage du Myocarde (PMRM), Université d'Angers (UA)-Université d'Angers (UA), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU de Saint-Brieuc, Hôpital Lapeyronie [Montpellier] (CHU), Assistance Publique - Hôpitaux de Marseille (APHM), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut de la Vision, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, University of Latvia (LU), Dipartimento di Scienza dei Materiali = Department of Materials Science [Milano-Bicocca], Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), MDM Laboratory, IMM-CNR, Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), Réseaux épuration et qualité des eaux (UR REBX), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), King Abdullah University of Science and Technology (KAUST), INSTITUTO NACIONAL DE INVESTIGACAO AGRARIA E VETERINARIA VILA DO CONDE PRT, Partenaires IRSTEA, Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Université de Médecine Carol Davila, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu' [Bucharest, Romania], Département Intelligence Ambiante et Systèmes Interactifs (DIASI), Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Department of photonics engineering, Danmarks Tekniske Universitet = Technical University of Denmark (DTU), Clinical sciences, Cardio-vascular diseases, Cardiology, Universität Leipzig [Leipzig], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Technical University of Denmark [Lyngby] (DTU), Université d'Angers (UA), Iung, Bernard, Delgado, Victoria, Rosenhek, Raphael, Price, Susanna, Prendergast, Bernard, Wendler, Olaf, De Bonis, Michele, Tribouilloy, Christophe, Evangelista, Arturo, Bogachev-Prokophiev, Alexander, Apor, Astrid, Ince, Hüseyin, Laroche, Cécile, Popescu, Bogdan A, Piérard, Luc, Haude, Michael, Hindricks, Gerhard, Ruschitzka, Frank, Windecker, Stephan, Bax, Jeroen J, Maggioni, Aldo, and Vahanian, Alec

Subjects
Male, Time Factors, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, heart valve diseases, valvular surgery, Cardiologists, 0302 clinical medicine, Time-to-Treatment/trends, Referral and Consultation/trends, Heart Valve Diseases/diagnosis, Medicine, echocardiography, 03.02. Klinikai orvostan, 030212 general & internal medicine, Prospective Studies, Practice Patterns, Physicians', 610 Medicine & health, Referral and Consultation, valvular heart disease, Middle Aged, Europe, Practice Guidelines as Topic, cardiovascular system, Healthcare Disparities/trends, transcatheter aortic valve replacement, Female, Guideline Adherence, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, guideline, Cardiologists/trends, medicine.medical_specialty, transcatheter intervention, Clinical Decision-Making, Time-to-Treatment, Europe/epidemiology, 03 medical and health sciences, Physiology (medical), Guideline Adherence/trends, Humans, Healthcare Disparities, Intensive care medicine, Aged, business.industry, medicine.disease, Practice Patterns, Physicians'/trends, Health Care Surveys, business, aged, 80 and over, guidelines as topic
Abstract

Background: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. Methods: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Results: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62–80 years); 1917 patients (26.5%) were ≥80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1–81.6) for aortic stenosis, 77.6% (95% CI, 69.9–84.0) for aortic regurgitation, 68.5% (95% CI, 60.8–75.4) for mitral stenosis, and 71.0% (95% CI, 66.4–75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. Conclusions: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation.

Published
2019

4. Rate vs. rhythm control and adverse outcomes among European patients with atrial fibrillation

Author

Dimitrios Tahmatzidis, Michał Mazurek, Cécile Laroche, Salvatore Novo, Marco Proietti, Gregory Y.H. Lip, Giuseppe Boriani, Yanish Purmah, and Yanish Purmah, Marco Proietti, Cecile´ Laroche, Michal Mazurek, Dimitrios Tahmatzidis, Giuseppe Boriani, Salvatore Novo, Gregory Y.H. Lip

Subjects
Male, Time Factors, Rate control, Action Potentials, Pilot Projects, 030204 cardiovascular system & hematology, Amiodarone, Action Potentials/drug effects, Heart Conduction System/drug effects, Cardiologists, 0302 clinical medicine, Heart Rate, Risk Factors, Cause of Death, Atrial Fibrillation, 030212 general & internal medicine, Registries, Practice Patterns, Physicians', Cause of death, Aged, 80 and over, All-cause death, Atrial fibrillation, Major adverse events, Registry, Rhythm control, Heart Rate/drug effects, Middle Aged, Europe, Treatment Outcome, Cohort, Cardiology, Healthcare Disparities/trends, Female, Cardiology and Cardiovascular Medicine, Anti-Arrhythmia Agents, Cardiologists/trends, medicine.drug, medicine.medical_specialty, Anti-Arrhythmia Agents/adverse effects, Europe/epidemiology, 03 medical and health sciences, Heart Conduction System, Physiology (medical), Internal medicine, Heart rate, medicine, Atrial Fibrillation/diagnosis, Humans, Healthcare Disparities, Adverse effect, Aged, business.industry, Proportional hazards model, medicine.disease, Practice Patterns, Physicians'/trends, Atrial fibrillation • Rate control • Rhythm control • Major adverse events • All-cause death • Registry, Propensity score matching, business
Abstract

Aim The impact of rate and rhythm control strategies on outcomes in patients with atrial fibrillation (AF) remains controversial. Our aims were: to report use of rate and rhythm control strategies in European patients from the EURObservational Research Program AF General Pilot Registry. Secondly, to evaluate outcomes according to assigned strategies. ........................................................................................................................................................... Methods and results Use of pure rate and rhythm control agents was described according to European regions. 1-year follow-up data were reported. Among rate control strategies, beta-blockers were the most commonly used drug. Proportions of patients assigned to rhythm control varied greatly between countries, and amiodarone was the most used rhythm control drug. Of the original 3119 patients, 1036 (33.2%) were assigned to rate control only and 355 (11.4%) to rhythm control only. Patients assigned to a rate control strategy were older (P < 0.0001) and more likely female (P = 0.0266). Patients assigned to a rate control strategy had higher rates for any thrombo-embolic event (P = 0.0245), cardiovascular death (P = 0.0437), and all-cause death (P < 0.0001). Kaplan–Meier analysis showed that rate control strategy was associated with a higher risk for all-cause death (P < 0.001). On Cox regression analysis, rate control strategy was independently associated with all-cause death (P = 0.0256). A propensity matched analysis only found a trend for the association between rate control and all-cause death (P = 0.0664). ........................................................................................................................................................... Conclusion In a European AF patients’ cohort, a pure rate control strategy was associated with a higher risk for adverse events at 1-year follow-up, and partially adjusted analysis suggested that rate control independently increased the risk for all-cause death. A fully adjusted propensity score matched analysis found that this association was no longer statistically significant, suggesting an important role of comorbidities in determining the higher risk for all-cause death.

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