PMID- 33273373
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20220531
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 134
IP  - 3
DP  - 2020 Dec 1
TI  - Association between use of amiodarone for non-valvular atrial fibrillation and 
      patient survival: from the prospective China Atrial Fibrillation Registry.
PG  - 309-317
LID - 10.1097/CM9.0000000000001270 [doi]
AB  - BACKGROUND: Post hoc analysis of the landmark atrial fibrillation follow-up 
      investigation of rhythm management trial revealed that amiodarone was associated 
      with higher risks of mortality, intensive care unit admission, and 
      non-cardiovascular death. We aim to evaluate the association between amiodarone 
      use and patient survival under updated medical mode and level using data from the 
      China Atrial Fibrillation (China-AF) Registry study. METHODS: Clinical data of 
      8161 non-valvular atrial fibrillation (NVAF) patients who were antiarrhythmic 
      drug (AAD)-naive before enrollment into the China-AF Registry, recruited between 
      August 2011 and February 2017, were collected. The primary outcome was all-cause 
      mortality. A Cox proportional hazard regression model was used to evaluate the 
      association between amiodarone use and the outcome. We also calculated the rate 
      of sinus rhythm maintenance at the penultimate follow-up. RESULTS: Compared with 
      6167 patients of non-AAD group, 689 patients of the amiodarone group were younger 
      (mean age 65.6 vs. 68.6 years), more frequently completed high school education, 
      had fewer comorbidities such as chronic heart failure, prior bleeding, and 
      stroke, and were more likely to be treated in tertiary hospitals while less 
      hospitalization. The proportion of persistent AF was much lower among users of 
      amiodarone, who were also less likely to be taking oral anticoagulants. The 
      patients in the amiodarone group had a statistically insignificant lower 
      incidence of all-cause mortality (2.44 vs. 3.91 per 100 person-years) over a mean 
      follow-up duration of 300.6 +/- 77.5 days. After adjusting for potential 
      confounders, amiodarone use was not significantly associated with a lower risk of 
      all-cause mortality (adjusted hazard ratio, 0.79; 95% confidence interval, 
      0.42-1.49). Sub-group analysis revealed the consistent results. The rate of sinus 
      rhythm maintenance at the penultimate follow-up in the amiodarone group was 
      significantly higher than in the non-AAD group. CONCLUSIONS: Our study indicated 
      that amiodarone use was not significantly associated with a lower risk of 1-year 
      all-cause mortality compared with a non-AAD strategy in "real-world" patients 
      with NVAF.
CI  - Copyright (c) 2021 The Chinese Medical Association, produced by Wolters Kluwer, 
      Inc. under the CC-BY-NC-ND license.
FAU - Hou, Xiao-Xia
AU  - Hou XX
AD  - Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, 
      Beijing 100176, China.
FAU - He, Liu
AU  - He L
AD  - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University; 
      National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, 
      China.
FAU - Du, Xin
AU  - Du X
AD  - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University; 
      National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, 
      China.
FAU - Wang, Guo-Hong
AU  - Wang GH
AD  - Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, 
      Beijing 100176, China.
FAU - Dong, Jian-Zeng
AU  - Dong JZ
AD  - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University; 
      National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, 
      China.
FAU - Ma, Chang-Sheng
AU  - Ma CS
AD  - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University; 
      National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, 
      China.
LA  - eng
PT  - Clinical Study
PT  - Journal Article
DEP - 20201201
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (Anti-Arrhythmia Agents)
RN  - N3RQ532IUT (Amiodarone)
SB  - IM
MH  - Aged
MH  - *Amiodarone/therapeutic use
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - *Atrial Fibrillation/drug therapy
MH  - China
MH  - Humans
MH  - Prospective Studies
MH  - Registries
PMC - PMC7846428
COIS- None.
EDAT- 2020/12/05 06:00
MHDA- 2021/05/15 06:00
PMCR- 2021/02/05
CRDT- 2020/12/04 05:39
PHST- 2020/12/05 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/12/04 05:39 [entrez]
PHST- 2021/02/05 00:00 [pmc-release]
AID - 00029330-202102050-00008 [pii]
AID - CMJ-2020-1102 [pii]
AID - 10.1097/CM9.0000000000001270 [doi]
PST - epublish
SO  - Chin Med J (Engl). 2020 Dec 1;134(3):309-317. doi: 10.1097/CM9.0000000000001270.