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Rate control and clinical outcomes in patients with atrial fibrillation and obstructive lung disease

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dc.contributor.authorYou, SC-
dc.contributor.authorAn, MH-
dc.contributor.authorYoon, D-
dc.contributor.authorBan, GY-
dc.contributor.authorYang, PS-
dc.contributor.authorYu, HT-
dc.contributor.authorPark, RW-
dc.contributor.authorJoung, B-
dc.date.accessioned2019-11-13T04:27:31Z-
dc.date.available2019-11-13T04:27:31Z-
dc.date.issued2018-
dc.identifier.issn1547-5271-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17582-
dc.description.abstractBACKGROUND: Rate-control medications are considered first-line treatment for patients with atrial fibrillation (AF). However, obstructive lung disease (OLD), a condition prevalent in those with AF, often makes it difficult to use those medications because of the lack of studies on new-onset AF in patients with OLD.
OBJECTIVE: The purpose of this study was to investigate clinical outcomes after administration of each class of rate-control medication in patients with concomitant AF and OLD (AF-OLD).
METHODS: This study used the entire database provided by the National Health Insurance Service from 2002 to 2015. Risk of all-cause mortality was compared between use of calcium channel blocker (CCB) and use of other drug classes in AF-OLD patients using Cox regression analyses after propensity score matching.
RESULTS: Among the 13,111 patients, the number of AF-OLD patients treated with a CCB, cardioselective beta-blocker (BB), nonselective BB, and digoxin was 2482, 2379, 2255, and 5995, respectively. The risk of mortality was lower with use of selective BB (hazard ratio [HR] 0.84: 95% confidence interval [CI] 0.75-0.94: P = .002) and nonselective BB (HR 0.85: 95% CI 0.77-0.95: P = .003) compared to use of CCBs. Digoxin use was related with worse survival, with marginal statistical significance (HR 1.09: 95% CI 1.00-1.18: P = .053).
CONCLUSION: Among patients with AF-OLD, rate-control treatment using selective and nonselective BB was associated with a significant reduction in mortality compared with CCB use. Further prospective randomized trials are required to confirm these findings.
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dc.language.isoen-
dc.subject.MESHAdrenergic beta-Antagonists/therapeutic use-
dc.subject.MESHAged-
dc.subject.MESHAnti-Arrhythmia Agents/therapeutic use-
dc.subject.MESHAtrial Fibrillation/complications-
dc.subject.MESHAtrial Fibrillation/drug therapy-
dc.subject.MESHAtrial Fibrillation/physiopathology-
dc.subject.MESHCause of Death/trends-
dc.subject.MESHDigoxin/therapeutic use-
dc.subject.MESHFemale-
dc.subject.MESHHeart Rate/drug effects-
dc.subject.MESHHeart Rate/physiology-
dc.subject.MESHHumans-
dc.subject.MESHLung Diseases, Obstructive/complications-
dc.subject.MESHLung Diseases, Obstructive/mortality-
dc.subject.MESHLung Diseases, Obstructive/physiopathology-
dc.subject.MESHMale-
dc.subject.MESHPropensity Score-
dc.subject.MESHRepublic of Korea/epidemiology-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Rate/trends-
dc.titleRate control and clinical outcomes in patients with atrial fibrillation and obstructive lung disease-
dc.typeArticle-
dc.identifier.pmid30509364-
dc.subject.keywordAdrenergic beta-antagonist-
dc.subject.keywordAtrial fibrillation-
dc.subject.keywordCalcium channel blocker-
dc.subject.keywordDigoxin-
dc.subject.keywordHeart rate-
dc.subject.keywordObstructive lung disease-
dc.contributor.affiliatedAuthor윤, 덕용-
dc.contributor.affiliatedAuthor박, 래웅-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.hrthm.2018.06.044-
dc.citation.titleHeart rhythm-
dc.citation.volume15-
dc.citation.number12-
dc.citation.date2018-
dc.citation.startPage1825-
dc.citation.endPage1832-
dc.identifier.bibliographicCitationHeart rhythm, 15(12). : 1825-1832, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1556-3871-
dc.relation.journalidJ015475271-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Biomedical Informatics
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