Cited 5 times in
Impact of frailty on early rhythm control outcomes in older adults with atrial fibrillation: A nationwide cohort study
DC Field | Value | Language |
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dc.contributor.author | 김대훈 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 유희태 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2023-03-22T02:17:37Z | - |
dc.date.available | 2023-03-22T02:17:37Z | - |
dc.date.issued | 2023-01 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/193561 | - |
dc.description.abstract | Purpose: Rhythm-control therapy administered early following the initial diagnosis of atrial fibrillation (AF) has superior cardiovascular outcomes compared to rate-control therapy. Frailty is a key factor in identifying older patients' potential for improvement after rhythm-control therapy. This study evaluated whether frailty affects the outcome of early rhythm-control therapy in older patients with AF. Methods: From the Korean National Health Insurance Service database (2005-2015), we collected 20,611 populations aged ≥65 years undergoing rhythm- or rate-control therapy initiated within 1 year of AF diagnosis. Participants were emulated by the EAST-AFNET4 trial, and stratified into non-frail, moderately frail, and highly frail groups based on the hospital frailty risk score (HFRS). A composite outcome of cardiovascular-related mortality, myocardial infarction, hospitalization for heart failure, and ischemic stroke was compared between rhythm- and rate-control. Results: Early rhythm-control strategy showed a 14% lower risk of the primary composite outcome in the non-frail group [weighted incidence 7.3 vs. 8.6 per 100 person-years; hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.79-0.93, p < 0.001] than rate-control strategy. A consistent trend toward a lower risk of early rhythm-control was observed in the moderately frail (HR 0.91, 95% CI 0.81-1.02, p = 0.09) and highly frail (HR 0.93, 95% CI 0.75-1.17, p = 0.55) groups. Conclusion: Although the degree attenuated with increasing frailty, the superiority of cardiovascular outcomes of early rhythm-control in AF treatment was maintained without increased risk for safety outcomes. An individualized approach is required on the benefits of early rhythm-control therapy in older patients with AF, regardless of their frailty status. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Frontiers Media S.A. | - |
dc.relation.isPartOf | FRONTIERS IN CARDIOVASCULAR MEDICINE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Impact of frailty on early rhythm control outcomes in older adults with atrial fibrillation: A nationwide cohort study | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Ga-In Yu | - |
dc.contributor.googleauthor | Daehoon Kim | - |
dc.contributor.googleauthor | Jung-Hoon Sung | - |
dc.contributor.googleauthor | Eunsun Jang | - |
dc.contributor.googleauthor | Hee Tae Yu | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Gregory Y H Lip | - |
dc.contributor.googleauthor | Pil-Sung Yang | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.identifier.doi | 10.3389/fcvm.2022.1050744 | - |
dc.contributor.localId | A00373 | - |
dc.contributor.localId | A01085 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02535 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A03609 | - |
dc.relation.journalcode | J04002 | - |
dc.identifier.eissn | 2297-055X | - |
dc.identifier.pmid | 36684588 | - |
dc.subject.keyword | atrial fibrillation | - |
dc.subject.keyword | frailty | - |
dc.subject.keyword | older adults | - |
dc.subject.keyword | rate-control | - |
dc.subject.keyword | rhythm-control | - |
dc.contributor.alternativeName | Kim, Dae Hoon | - |
dc.contributor.affiliatedAuthor | 김대훈 | - |
dc.contributor.affiliatedAuthor | 김태훈 | - |
dc.contributor.affiliatedAuthor | 박희남 | - |
dc.contributor.affiliatedAuthor | 유희태 | - |
dc.contributor.affiliatedAuthor | 이문형 | - |
dc.contributor.affiliatedAuthor | 정보영 | - |
dc.citation.volume | 9 | - |
dc.citation.startPage | 1050744 | - |
dc.identifier.bibliographicCitation | FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.9 : 1050744, 2023-01 | - |
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