Rate control and clinical outcomes in patients with atrial fibrillation and obstructive lung disease

Seng Chan You, Min Ho An, Dukyong Yoon, Ga Young Ban, Pil Sung Yang, Hee Tae Yu, Rae Woong Park, Boyoung Joung

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Rate-control medications are considered first-line treatment for patients with atrial fibrillation (AF). However, obstructive lung disease (OLD), a condition prevalent in those with AF, often makes it difficult to use those medications because of the lack of studies on new-onset AF in patients with OLD. Objective: The purpose of this study was to investigate clinical outcomes after administration of each class of rate-control medication in patients with concomitant AF and OLD (AF-OLD). Methods: This study used the entire database provided by the National Health Insurance Service from 2002 to 2015. Risk of all-cause mortality was compared between use of calcium channel blocker (CCB) and use of other drug classes in AF-OLD patients using Cox regression analyses after propensity score matching. Results: Among the 13,111 patients, the number of AF-OLD patients treated with a CCB, cardioselective β-blocker (BB), nonselective BB, and digoxin was 2482, 2379, 2255, and 5995, respectively. The risk of mortality was lower with use of selective BB (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.75–0.94; P =.002) and nonselective BB (HR 0.85; 95% CI 0.77–0.95; P =.003) compared to use of CCBs. Digoxin use was related with worse survival, with marginal statistical significance (HR 1.09; 95% CI 1.00–1.18; P =.053). Conclusion: Among patients with AF-OLD, rate-control treatment using selective and nonselective BB was associated with a significant reduction in mortality compared with CCB use. Further prospective randomized trials are required to confirm these findings.

Original languageEnglish
Pages (from-to)1825-1832
Number of pages8
JournalHeart Rhythm
Volume15
Issue number12
DOIs
Publication statusPublished - 2018 Dec

Bibliographical note

Funding Information:
This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C0992 ). Conflicts of interest: None declared. Dr You and Min Ho An contributed equally to this work.

Publisher Copyright:
© 2018 Heart Rhythm Society

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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