Efficacy and safety of dronedarone by atrial fibrillation history duration : Insights from the ATHENA study
(2020) In Clinical Cardiology 43(12). p.1469-1477- Abstract
Background: Atrial fibrillation/atrial flutter (AF/AFL) burden increases with increasing duration of AF/AFL history. Hypothesis: Outcomes with dronedarone may also be impacted by duration of AF/AFL history. Methods: In this post hoc analysis of ATHENA, efficacy and safety of dronedarone vs placebo were assessed in groups categorized by time from first known AF/AFL episode to randomization (ie, duration of AF/AFL history): <3 months (short), 3 to <24 months (intermediate), and ≥ 24 months (long). Results: Of 2859 patients with data on duration of AF/AFL history, 45.3%, 29.6%, and 25.1% had short, intermediate, and long histories, respectively. Patients in the long history group had the highest prevalence of structural heart disease... (More)
Background: Atrial fibrillation/atrial flutter (AF/AFL) burden increases with increasing duration of AF/AFL history. Hypothesis: Outcomes with dronedarone may also be impacted by duration of AF/AFL history. Methods: In this post hoc analysis of ATHENA, efficacy and safety of dronedarone vs placebo were assessed in groups categorized by time from first known AF/AFL episode to randomization (ie, duration of AF/AFL history): <3 months (short), 3 to <24 months (intermediate), and ≥ 24 months (long). Results: Of 2859 patients with data on duration of AF/AFL history, 45.3%, 29.6%, and 25.1% had short, intermediate, and long histories, respectively. Patients in the long history group had the highest prevalence of structural heart disease and were more likely to be in AF/AFL at baseline. Placebo-treated patients in the long history group also had the highest incidence of AF/AFL recurrence and cardiovascular (CV) hospitalization during the study. The risk of first CV hospitalization/death from any cause was lower with dronedarone vs placebo in patients with short (hazard ratio, 0.79 [95% confidence interval: 0.65-0.96]) and intermediate (0.72 [0.56-0.92]) histories; a trend favoring dronedarone was also observed in patients with long history (0.84 [0.66-1.07]). A similar pattern was observed for first AF/AFL recurrence. No new drug-related safety issues were identified. Conclusions: Patients with long AF/AFL history had the highest burden of AF/AFL at baseline and during the study. Dronedarone significantly improved efficacy vs placebo in patients with short and intermediate AF/AFL histories. While exploratory, these results support the potential value in initiating rhythm control treatment early in patients with AF/AFL.
(Less)
- author
- Blomström-Lundqvist, Carina ; Marrouche, Nassir ; Connolly, Stuart ; Corp dit Genti, Valérie ; Wieloch, Mattias LU ; Koren, Andrew and Hohnloser, Stefan H.
- organization
- publishing date
- 2020-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antiarrhythmic therapy, atrial fibrillation, atrial flutter, dronedarone, duration of atrial fibrillation history
- in
- Clinical Cardiology
- volume
- 43
- issue
- 12
- pages
- 9 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85092936022
- pmid:33080088
- ISSN
- 0160-9289
- DOI
- 10.1002/clc.23463
- language
- English
- LU publication?
- yes
- id
- 48af0527-d2b0-4705-989d-d62ad159b9af
- date added to LUP
- 2020-11-12 07:46:49
- date last changed
- 2024-06-27 01:13:42
@article{48af0527-d2b0-4705-989d-d62ad159b9af,
abstract = {{<p>Background: Atrial fibrillation/atrial flutter (AF/AFL) burden increases with increasing duration of AF/AFL history. Hypothesis: Outcomes with dronedarone may also be impacted by duration of AF/AFL history. Methods: In this post hoc analysis of ATHENA, efficacy and safety of dronedarone vs placebo were assessed in groups categorized by time from first known AF/AFL episode to randomization (ie, duration of AF/AFL history): <3 months (short), 3 to <24 months (intermediate), and ≥ 24 months (long). Results: Of 2859 patients with data on duration of AF/AFL history, 45.3%, 29.6%, and 25.1% had short, intermediate, and long histories, respectively. Patients in the long history group had the highest prevalence of structural heart disease and were more likely to be in AF/AFL at baseline. Placebo-treated patients in the long history group also had the highest incidence of AF/AFL recurrence and cardiovascular (CV) hospitalization during the study. The risk of first CV hospitalization/death from any cause was lower with dronedarone vs placebo in patients with short (hazard ratio, 0.79 [95% confidence interval: 0.65-0.96]) and intermediate (0.72 [0.56-0.92]) histories; a trend favoring dronedarone was also observed in patients with long history (0.84 [0.66-1.07]). A similar pattern was observed for first AF/AFL recurrence. No new drug-related safety issues were identified. Conclusions: Patients with long AF/AFL history had the highest burden of AF/AFL at baseline and during the study. Dronedarone significantly improved efficacy vs placebo in patients with short and intermediate AF/AFL histories. While exploratory, these results support the potential value in initiating rhythm control treatment early in patients with AF/AFL.</p>}},
author = {{Blomström-Lundqvist, Carina and Marrouche, Nassir and Connolly, Stuart and Corp dit Genti, Valérie and Wieloch, Mattias and Koren, Andrew and Hohnloser, Stefan H.}},
issn = {{0160-9289}},
keywords = {{antiarrhythmic therapy; atrial fibrillation; atrial flutter; dronedarone; duration of atrial fibrillation history}},
language = {{eng}},
number = {{12}},
pages = {{1469--1477}},
publisher = {{Wiley-Blackwell}},
series = {{Clinical Cardiology}},
title = {{Efficacy and safety of dronedarone by atrial fibrillation history duration : Insights from the ATHENA study}},
url = {{http://dx.doi.org/10.1002/clc.23463}},
doi = {{10.1002/clc.23463}},
volume = {{43}},
year = {{2020}},
}