Abstract | BACKGROUND: OBJECTIVE: To study the use and outcomes of AAD therapy in anticoagulated patients with AF. METHODS: RESULTS: Of 14,264 patients randomized, 1681 (11.8%) were treated with an AAD (1144 [8%] with amiodarone and 537 [3.8%] with other AADs). Amiodarone-treated patients were less often female (38% vs 48%), had more persistent AF (64% vs 40%), and more concomitant heart failure (71% vs 41%) than were patients receiving other AADs. Patients receiving no AAD more closely resembled amiodarone-treated patients. Time in therapeutic range was significantly lower in warfarin-treated patients receiving amiodarone than in those receiving no AAD (50% vs 58%; P < .0001). Compared with no AAD, neither amiodarone (adjusted hazard ratio [HR] 0.98; 95% confidence interval [CI] 0.74-1.31; P = .9) nor other AADs (adjusted HR 0.66; 95% CI 0.37-1.17; P = .15) were associated with increased mortality. Similar results were observed for embolic and bleeding outcomes. Treatment effects of rivaroxaban vs warfarin in patients receiving no AAD were consistent with results from the overall trial (primary end point: adjusted HR 0.82; 95% CI 0.68-0.98; Pinteraction = .06; safety end point: adjusted HR 1.12; 95% CI 0.90-1.24; Pinteraction = .33). CONCLUSION: Treatment with AADs was not associated with increased morbidity or mortality in anticoagulated patients with AF. The effect of amiodarone on outcomes in patients receiving rivaroxaban requires further investigation.
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Authors | Benjamin A Steinberg, Anne S Hellkamp, Yuliya Lokhnygina, Jonathan L Halperin, Günter Breithardt, Rod Passman, Graeme J Hankey, Manesh R Patel, Richard C Becker, Daniel E Singer, Werner Hacke, Scott D Berkowitz, Christopher C Nessel, Kenneth W Mahaffey, Keith A A Fox, Robert M Califf, Jonathan P Piccini, ROCKET AF Steering Committee and Investigators |
Journal | Heart rhythm
(Heart Rhythm)
Vol. 11
Issue 6
Pg. 925-32
(Jun 2014)
ISSN: 1556-3871 [Electronic] United States |
PMID | 24833235
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Anti-Arrhythmia Agents
- Anticoagulants
- Morpholines
- Thiophenes
- Rivaroxaban
- Amiodarone
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Topics |
- Aged
- Amiodarone
(therapeutic use)
- Anti-Arrhythmia Agents
(therapeutic use)
- Anticoagulants
(therapeutic use)
- Atrial Fibrillation
(drug therapy, mortality)
- Female
- Humans
- Intention to Treat Analysis
- Male
- Middle Aged
- Morpholines
(therapeutic use)
- Rivaroxaban
- Thiophenes
(therapeutic use)
- Treatment Outcome
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