Arrhythmias & electrophysiologySecondary analysis
Prevalence and severity of atrial cardiomyopathy in patients with recently diagnosed atrial fibrillation and stroke risk factors and its association with early rhythm control: a secondary analysis of EAST-AFNET 4
- Secondary analysis of the EAST-AFNET 4 randomised trial
- prespecified analysis
Authors' conclusion
Most patients have signs of atrial cardiomyopathy in the first year after AF diagnosis. Patients with advanced stages of atrial cardiomyopathy had a higher rate of primary outcome events and more recurrent AF. Nevertheless, early rhythm control therapy retains its efficacy across the spectrum of atrial cardiomyopathy severities.
Study context
- Population
- Patients with recently diagnosed atrial fibrillation (AF) and stroke risk factors
- Comparison
- Atrial cardiomyopathy categories; interaction with early rhythm control
- Primary endpoint
- Primary outcome of EAST-AFNET 4:
- CV death
- Stroke
- Hospitalization for HF
- ACS
Primary result
As reported in the abstract
At least mildly elevated left atrial (LA) size
69%
Prolonged PR interval (≥200 ms)
23%
NT-proBNP > 365 pg/mL
56%
Early rhythm control effective with and without atrial cardiomyopathy
Pinteraction = 0.160
Further findings
First primary outcome, severe atrial cardiomyopathy (highest tertile of LA size, PR interval and NT-proBNP)
| Comparison | HR (CI) | P value | |
|---|---|---|---|
| Severe atrial cardiomyopathy | 7.97 (2.32–27.37) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
ANGPT2 and BMP10 (exploratory)
- ANGPT2 associated with LA diameter and atrial cardiomyopathy severity/stage; BMP 10 not associated
- exploratory analysis
Original publication
Summarised from the published abstract; every number is checked against it