Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT

ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal corona...

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Veröffentlicht in:Journal of the National Medical Association 2018-08, Vol.110 (4), p.343-351
Hauptverfasser: Haywood, L. Julian, Davis, Barry R., Piller, Linda B., Simpson, Lara M., Ghosh, Alokananda, Einhorn, Paula T., Ford, Charles E., Probstfield, Jeffrey L., Soliman, Elsayed Z., Wright, Jackson T.
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Sprache:eng
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Zusammenfassung:ALLHAT, a randomized, double-blind, active-controlled, multicenter clinical trial of high risk hypertensive participants, compared treatment with an ACE-inhibitor (lisinopril) or calcium channel blocker (amlodipine) with a diuretic (chlorthalidone). Primary outcome was the occurrence of fatal coronary heart disease or nonfatal myocardial infarction. For this report, post-hoc analyses were conducted to determine the contribution of baseline characteristics of participants with or without baseline or incident atrial fibrillation (AF) and atrial flutter (AFL) to stroke, heart failure (HF), coronary heart disease (CHD), and mortality outcomes. Minnesota Coding of baseline and biennial in-trial ECGs was used to determine the 334 baseline and 537 incident AF/AFL cases, respectively participants with AF/AFL: Cox regression was used to estimate hazard ratios of presence versus absence of either baseline or incident AF/AFL (as time-dependent covariate) for occurrence of stroke, CHD, HF, or mortality, while adjusting for selected baseline characteristics. Adjusted Cox regression was used to obtain hazard ratios (HRs) for presence versus absence of selected baseline characteristics among those with and without either baseline or incident AF/AFL. After adjusting for baseline characteristics, baseline AF/AFL was associated with stroke, HF, and mortality (HRs [95% CIs] 3.18, [2.34–4.33]; 2.65 [2.02–3.49]; and 2.10 [CI, 1.73–2.55], respectively, P 
ISSN:0027-9684
1943-4693
DOI:10.1016/j.jnma.2017.07.003