Stroke and Cardiovascular Events After Ablation or Antiarrhythmic Drugs for Treatment of Patients With Atrial Fibrillation

Catheter ablation and antiarrhythmic drugs (AADs) are the most common rhythm-control strategies for atrial fibrillation (AF). Data comparing the rate of stroke and cardiovascular events between the treatment strategies are limited. Therefore, this observational study uses claims data to compare rate...

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Veröffentlicht in:The American journal of cardiology 2018-05, Vol.121 (10), p.1192-1199
Hauptverfasser: Mansour, Moussa, Heist, E. Kevin, Agarwal, Rahul, Bunch, T. Jared, Karst, Edward, Ruskin, Jeremy N., Mahapatra, Srijoy
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container_end_page 1199
container_issue 10
container_start_page 1192
container_title The American journal of cardiology
container_volume 121
creator Mansour, Moussa
Heist, E. Kevin
Agarwal, Rahul
Bunch, T. Jared
Karst, Edward
Ruskin, Jeremy N.
Mahapatra, Srijoy
description Catheter ablation and antiarrhythmic drugs (AADs) are the most common rhythm-control strategies for atrial fibrillation (AF). Data comparing the rate of stroke and cardiovascular events between the treatment strategies are limited. Therefore, this observational study uses claims data to compare rate of cardiovascular hospitalization and stroke for patients with AF treated with ablation or AADs. Patients in the MarketScan dataset with AF between January 2010 and December 2014 were categorized in the ablation group if an atrial catheter ablation was performed, or in the AAD group if a relevant AAD was prescribed for AF but no ablation was performed. One year of history was required, and the index event was selected as the most recent ablation or AAD prescription closest to January 1, 2013. A 2:1 propensity score match was performed for age, gender, co-morbidities, and total medical cost in the year before index event. Outcomes included thromboembolic event (ischemic stroke, transient ischemic attack, or systemic embolism) and all cardiovascular hospitalizations. Of the 164,639 patients in the AAD group, 29,456 were matched to the 14,728 ablation patients. There were no significant differences in age (64 ± 10 in both groups), gender (58% male), or CHA2DS2-VASc score (3.2 ± 1.3). Risk of hospitalization with primary diagnosis of thromboembolic event was 41% greater in the AADs group (p 
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Kevin ; Agarwal, Rahul ; Bunch, T. Jared ; Karst, Edward ; Ruskin, Jeremy N. ; Mahapatra, Srijoy</creator><creatorcontrib>Mansour, Moussa ; Heist, E. Kevin ; Agarwal, Rahul ; Bunch, T. Jared ; Karst, Edward ; Ruskin, Jeremy N. ; Mahapatra, Srijoy</creatorcontrib><description>Catheter ablation and antiarrhythmic drugs (AADs) are the most common rhythm-control strategies for atrial fibrillation (AF). Data comparing the rate of stroke and cardiovascular events between the treatment strategies are limited. Therefore, this observational study uses claims data to compare rate of cardiovascular hospitalization and stroke for patients with AF treated with ablation or AADs. Patients in the MarketScan dataset with AF between January 2010 and December 2014 were categorized in the ablation group if an atrial catheter ablation was performed, or in the AAD group if a relevant AAD was prescribed for AF but no ablation was performed. 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Patients in the MarketScan dataset with AF between January 2010 and December 2014 were categorized in the ablation group if an atrial catheter ablation was performed, or in the AAD group if a relevant AAD was prescribed for AF but no ablation was performed. One year of history was required, and the index event was selected as the most recent ablation or AAD prescription closest to January 1, 2013. A 2:1 propensity score match was performed for age, gender, co-morbidities, and total medical cost in the year before index event. Outcomes included thromboembolic event (ischemic stroke, transient ischemic attack, or systemic embolism) and all cardiovascular hospitalizations. Of the 164,639 patients in the AAD group, 29,456 were matched to the 14,728 ablation patients. There were no significant differences in age (64 ± 10 in both groups), gender (58% male), or CHA2DS2-VASc score (3.2 ± 1.3). 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subjects Ablation
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - therapeutic use
Antiarrhythmics
Anticoagulants
Anticoagulants - therapeutic use
Arrhythmia
Atrial Fibrillation - complications
Atrial Fibrillation - therapy
Cardiac arrhythmia
Cardiovascular Diseases - epidemiology
Catheter Ablation
Catheters
Cohort Studies
Drugs
Embolism
Female
Fibrillation
Health risks
Hospitalization
Humans
Insurance coverage
Ischemia
Ischemic Attack, Transient - epidemiology
Ischemic Attack, Transient - etiology
Ischemic Attack, Transient - prevention & control
Low density lipoprotein
Male
Medical instruments
Middle Aged
Patients
Retrospective Studies
Stroke
Stroke - epidemiology
Stroke - etiology
Stroke - prevention & control
Thromboembolism
Thromboembolism - epidemiology
Thromboembolism - etiology
Thromboembolism - prevention & control
Transient ischemic attack
title Stroke and Cardiovascular Events After Ablation or Antiarrhythmic Drugs for Treatment of Patients With Atrial Fibrillation
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