| Enhanced cardiovascular morbidity and mortality during rhythm control treatment in persistent atrial fibrillation in hypertensives: data of the RACE study. | |
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MedLine Citation:
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PMID: 17272359 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To investigate the influence of hypertension on morbidity and mortality during rate and rhythm control in patients with persistent atrial fibrillation (AF). METHODS AND RESULTS: In the RAte Control vs. Electrical cardioversion (RACE) study, 522 patients (256 with hypertension) were randomized to rate or rhythm control. The occurrence of cardiovascular morbidity and mortality was compared between patients with and without hypertension. Patients with hypertension were older (69 +/- 8 vs. 67 +/- 9 years, P = 0.01), more female (P < 0.001), had more diabetes (P = 0.005), a higher CHADS(2) score (2.2 +/- 1.0 vs. 1.0 +/- 0.9, P < 0.001), and higher systolic and diastolic blood pressures. Septal and posterior wall thicknesses were higher in hypertensives. Complaints related to AF were similar. After a median follow-up of 2.4 (range 0-3.4) years more endpoints occurred in hypertensives (25 vs. 15%). Randomized treatment strategy, i.e. rate or rhythm control, influenced the occurrence of the primary endpoint only in hypertensives. Hypertensives treated with rhythm control experienced most endpoints (incidence rates/100 person-years 13.3 vs. 7.2, relative risk 0.5 [0.3-0.9], P = 0.02), mainly thromboembolic complications, adverse effects of antiarrhythmics, and pacemaker implantations. CONCLUSION: In persistent AF patients with hypertension, a pharmacological rhythm control approach is associated with enhanced cardiovascular morbidity and mortality. Therefore, rate-control strategy should be considered in these patients. |
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Authors:
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Michiel Rienstra; Dirk J Van Veldhuisen; Harry J G M Crijns; Isabelle C Van Gelder; |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-02-01 |
Journal Detail:
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Title: European heart journal Volume: 28 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-16 Completed Date: 2008-02-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 741-51 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / therapeutic use Atrial Fibrillation / complications, mortality, physiopathology, therapy* Blood Pressure / physiology Electric Countershock / methods* Female Heart Failure / etiology Humans Hypertension / complications*, mortality, physiopathology Male Thromboembolism / etiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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