Background: Using data from the ODYSSEY OUTCOMES trial (NCT01663402), we sought to identify factors associated with the development of incident atrial fibrillation in patients with recent acute coronary syndrome without prior atrial fibrillation and to determine whether alirocumab treatment influenced risk of incident atrial fibrillation.
Methods: ODYSSEY OUTCOMES compared alirocumab treatment with placebo in 18,924 patients with recent acute coronary syndrome and dyslipidemia despite high-intensity or maximum-tolerated statin therapy. The primary outcome of major adverse cardiovascular events (MACE) comprised death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischemic stroke, or unstable angina requiring hospitalization. Patients were classified as having previous atrial fibrillation (present prior to or at randomization) or no previous atrial fibrillation. A multivariable model was used to determine factors associated with incident atrial fibrillation.
Results: Among 18,262 participants without prior atrial fibrillation at baseline, 499 (2.7%) had incident atrial fibrillation during follow-up. Older age, history of heart failure or myocardial infarction, and higher body mass index were significantly associated with incident atrial fibrillation. Treatment with alirocumab or placebo did not influence the cumulative incidence of atrial fibrillation (hazard ratio 0.91; 95% confidence interval, 0.77-1.09). Patients with vs without a history of atrial fibrillation had a higher incidence of MACE (8.8 vs 3.7 events per 100 patient-years), without significant interaction between atrial fibrillation and randomized treatment on risk of MACE (P = .78).
Conclusions: While alirocumab did not modify risk of incident atrial fibrillation after acute coronary syndrome, it did reduce the risk of MACE, regardless of prior atrial fibrillation history. History of atrial fibrillation is an independent predictor of recurrent cardiovascular events after acute coronary syndrome.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjmed.2022.02.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Associations of Social, Behavioral, and Clinical Factors With Sex Differences in Stroke Recurrence and Poststroke Mortality.
Circ Cardiovasc Qual Outcomes
January 2025
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor. (C.C., L.B.M., L.D.L.).
Background: Few population-based studies have assessed sex differences in stroke recurrence. In addition, contributors to sex differences in recurrence and poststroke mortality, including social factors, are unclear. We investigated sex differences in these outcomes and the contribution of social, clinical, and behavioral factors to the sex differences.
View Article and Find Full Text PDFPrediabetes and atrial fibrillation risk stratification, phenotyping, and possible reversal to normoglycemia.
World J Diabetes
January 2025
Department of Internal Medicine, University of Tabuk, Tabuk 51941, Tabuk, Saudi Arabia.
Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables. The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity. Because of that, it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.
View Article and Find Full Text PDFComparison of Cardiac Magnetic Resonance Imaging Findings and Prognostic Measures in Nondilated Cardiomyopathy and Dilated Cardiomyopathy.
Cardiol Res Pract
January 2025
Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Nondilated left ventricular cardiomyopathy (NDLVC) is a newly defined category of cardiomyopathy. We sought to evaluate and compare the phenotype of NDLVC with DCM using cardiac magnetic resonance (CMR) imaging and to investigate the prognostic significance of these conditions. One hundred and fifty patients suspected of having cardiomyopathy referred for CMR were recruited.
View Article and Find Full Text PDFEffectiveness and Safety of Dose-Specific DOACs in Patients With Atrial Fibrillation: A Systematic Review and Network Meta-Analysis.
Cardiovasc Ther
January 2025
College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan-si, Gyeonggi-do, Republic of Korea.
Dose adjustments of direct-acting oral anticoagulants (DOACs) for atrial fibrillation are based on pivotal clinical trials assessing their effectiveness and safety in controlled settings. However, the appropriateness of these dosing strategies in real-world practice is uncertain. The purpose of this study is to compare the effectiveness and safety of dose-specific DOACs with those of warfarin.
View Article and Find Full Text PDFPopulation-Based Analysis of Late Outcomes of Mitral Valve Repair for Degenerative Mitral Valve Regurgitation.
JACC Adv
December 2024
Department of Cardiovascular Surgery, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Background: Population-based analyses may reduce uncertainty related to referral bias and/or incomplete follow-up.
Objectives: This study analyzed long-term mortality and durability of mitral valve repair in a geographically defined population with clinical and echocardiographic follow-up.
Methods: We used the Rochester Epidemiology Project to identify 153 Olmsted County patients who underwent mitral valve repair for degenerative regurgitation from 1993 to 2018.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!