In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: Dronedarone was developed to improve outcomes in patients with atrial fibrillation (AF) compared with other antiarrhythmic drugs. Hypothesis: Dronedarone may offer better cardiovascular outcomes compared to non-dronedarone antiarrhythmic drugs. Methods: Taiwan National Health Insurance Research Database were retrieved between 2012-2017 for patients with AF. Patients not taking antiarrhythmic drugs, having history of bradycardia, heart block, heart failure admission, mitral stenosis, prosthetic valve, incomplete demographic data, and follow-up less than 3 months were excluded. Protocol 1, outcomes of patients with AF using dronedarone were compared to non-dronedarone antiarrhythmic drugs (amiodarone, propafenone, flecainide, sotalol). In Protocol 2, outcomes of patients with AF using dronedarone were compared to amiodarone, the most frequently used antiarrhythmic drug. Propensity score matching performed to reduce bias. Primary outcomes were acute myocardial infarction (AMI), ischemic stroke/systemic embolism (IS/SE), intracranial hemorrhage (ICH), major bleeding, cardiovascular death, and all-cause mortality. Secondary outcome was composite of AMI, ischemic stroke, and cardiovascular death (MACE). Results: In Protocol 1, after 1:3 matching, 2,032 dronedarone patients and 6,096 non-dronedarone patients were analyzed. Dronedarone was associated with significantly lower IS/SE (p=0.0033), ICH (p=0.0111), major bleeding (p=0.0230), cardiovascular death (p 〈 0.0001), all-cause mortality (p 〈 0.0001) and MACE (p 〈 0.0001), without difference in AMI, compared to non-dronedarone. In Protocol 2, after 1:3 matching, 1,994 dronedarone patients and 5,982 amiodarone patients were analyzed. Dronedarone was associated with significantly lower IS/SE (p=0.0071), cardiovascular death (p 〈 0.0001), all-cause mortality (p 〈 0.0001), and MACE (p 〈 0.0001), without differences in AMI, ICH, and major bleeding, compared to amiodarone. Use of anticoagulants and doses were similar between groups in both protocols. Conclusions: Dronedarone was associated with lower ischemic stroke/systemic embolism, cardiovascular death, all-cause mortality and MACE compared to non-dronedarone or directly to amiodarone.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.11146
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
