Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_4214CB420962
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation.
Journal
Open heart
Author(s)
Moor J., Kuhne M., Moschovitis G., Kobza R., Netzer S., Auricchio A., Beer J.H., Bonati L., Reichlin T., Conen D., Osswald S., Rodondi N., Clair C., Baumgartner C., Aubert C.E.
ISSN
2053-3624 (Print)
ISSN-L
2053-3624
Publication state
Published
Issued date
12/08/2024
Peer-reviewed
Oui
Volume
11
Number
2
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Abstract
Sex differences occur in atrial fibrillation (AF), including age at first manifestation, pathophysiology, treatment allocation, complication rates and quality of life. However, optimal doses of cardiovascular pharmacotherapy used in women with AF with or without heart failure (HF) are unclear. We investigated sex-specific associations of beta-blocker and renin-angiotensin system (RAS) inhibitor doses with cardiovascular outcomes in patients with AF or AF with concomitant HF.
We used data from the prospective Basel Atrial Fibrillation and Swiss Atrial Fibrillation cohorts on patients with AF. The outcome was major adverse cardiovascular events (MACEs), including death, myocardial infarction, stroke, systemic embolisation and HF-related hospitalisation. Predictors of interest were spline (primary analysis) or quartiles (secondary analysis) of beta-blocker or RAS inhibitor dose in per cent of the maximum dose (reference), in interaction with sex. Cox models were adjusted for demographics, comorbidities and comedication.
Among 3961 patients (28% women), MACEs occurred in 1113 (28%) patients over a 5-year median follow-up. Distributions of RAS inhibitor and beta-blocker doses were similar in women and men. Cox models revealed no association between beta-blocker dose or RAS inhibitor dose and MACE. In a subgroup of patients with AF and HF, the lowest hazard of MACE was observed in women prescribed 100% of the RAS inhibitor dose. However, there was no association between RAS dose quartiles and MACE.
In this study of patients with AF, doses of beta-blockers and RAS inhibitors did not differ by sex and were not associated with MACE overall.
Keywords
Humans, Atrial Fibrillation/drug therapy, Atrial Fibrillation/diagnosis, Atrial Fibrillation/complications, Female, Male, Aged, Prospective Studies, Sex Factors, Adrenergic beta-Antagonists/administration & dosage, Adrenergic beta-Antagonists/adverse effects, Risk Factors, Middle Aged, Switzerland/epidemiology, Treatment Outcome, Follow-Up Studies, Risk Assessment/methods, Angiotensin-Converting Enzyme Inhibitors/administration & dosage, Angiotensin-Converting Enzyme Inhibitors/adverse effects, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Dose-Response Relationship, Drug, Time Factors, Heart Failure/diagnosis, Heart Failure/physiopathology, Aged, 80 and over, Arrhythmias, Cardiac, Atrial Fibrillation, Heart Failure, Pharmacology
Pubmed
Open Access
Yes
Create date
19/08/2024 10:31
Last modification date
20/08/2024 7:27
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