Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation
Abstract Progression from paroxysmal to persistent atrial fibrillation (AF) is linked to adverse clinical outcomes. The present study sought to clarify whether angiotensin receptor-neprilysin inhibitor (ARNI) can delay AF progression. A retrospective cohort study was conducted on consecutive patient...
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Nature Portfolio
2023-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-30349-w |
| _version_ | 1797864854272344064 |
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| author | Youzheng Dong Zhenyu Zhai Jihong Wang Zhen Xia Zirong Xia Bo Zhu Quanbing Dong Qing Li Juxiang Li |
| author_facet | Youzheng Dong Zhenyu Zhai Jihong Wang Zhen Xia Zirong Xia Bo Zhu Quanbing Dong Qing Li Juxiang Li |
| author_sort | Youzheng Dong |
| collection | DOAJ |
| description | Abstract Progression from paroxysmal to persistent atrial fibrillation (AF) is linked to adverse clinical outcomes. The present study sought to clarify whether angiotensin receptor-neprilysin inhibitor (ARNI) can delay AF progression. A retrospective cohort study was conducted on consecutive patients with paroxysmal AF admitted at the Second Affiliated Hospital of Nanchang University between January 2017 and January 2022. The risk of AF progression from paroxysmal to persistent was compared between paroxysmal patients treated with ARNI and those who received an angiotensin receptor blocker (ARB). Seven-day Holter monitoring was performed to identify persistent AF. Propensity-score matched analysis was performed to compare the two groups. Cox-regression was used to estimate the hazard ratio (HR) for AF progression events. A total of 1083 patients were screened, and 113 patients in the ARB group and 57 patients in the ARNI group were eligible for analysis. Before propensity-score matching, the ARNI therapy was associated with a lower risk of AF progression than the ARB therapy (HR 0.34; 95% confidence interval [CI] 0.14–0.81; P = 0.015) after a median follow-up of 705 (interquartile range [IQR] 512 to 895) days. Among 170 patients, 47 ARNI-treated patients were successfully matched to 47 ARB-treated patients. After a median follow-up of 724 (541–929) days, compared to ARB, ARNI significantly reduced the risk of AF progression (HR 0.32; 95% CI 0.12–0.88; P = 0.016). ARNI may be superior to ARB in reducing the risk of progression from paroxysmal to persistent AF. |
| first_indexed | 2024-04-09T22:58:43Z |
| format | Article |
| id | doaj.art-ad64a7a0a96748c6a0a34eb1d353b9eb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:58:43Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ad64a7a0a96748c6a0a34eb1d353b9eb2023-03-22T11:07:36ZengNature PortfolioScientific Reports2045-23222023-02-011311710.1038/s41598-023-30349-wAngiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillationYouzheng Dong0Zhenyu Zhai1Jihong Wang2Zhen Xia3Zirong Xia4Bo Zhu5Quanbing Dong6Qing Li7Juxiang Li8Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang UniversityAbstract Progression from paroxysmal to persistent atrial fibrillation (AF) is linked to adverse clinical outcomes. The present study sought to clarify whether angiotensin receptor-neprilysin inhibitor (ARNI) can delay AF progression. A retrospective cohort study was conducted on consecutive patients with paroxysmal AF admitted at the Second Affiliated Hospital of Nanchang University between January 2017 and January 2022. The risk of AF progression from paroxysmal to persistent was compared between paroxysmal patients treated with ARNI and those who received an angiotensin receptor blocker (ARB). Seven-day Holter monitoring was performed to identify persistent AF. Propensity-score matched analysis was performed to compare the two groups. Cox-regression was used to estimate the hazard ratio (HR) for AF progression events. A total of 1083 patients were screened, and 113 patients in the ARB group and 57 patients in the ARNI group were eligible for analysis. Before propensity-score matching, the ARNI therapy was associated with a lower risk of AF progression than the ARB therapy (HR 0.34; 95% confidence interval [CI] 0.14–0.81; P = 0.015) after a median follow-up of 705 (interquartile range [IQR] 512 to 895) days. Among 170 patients, 47 ARNI-treated patients were successfully matched to 47 ARB-treated patients. After a median follow-up of 724 (541–929) days, compared to ARB, ARNI significantly reduced the risk of AF progression (HR 0.32; 95% CI 0.12–0.88; P = 0.016). ARNI may be superior to ARB in reducing the risk of progression from paroxysmal to persistent AF.https://doi.org/10.1038/s41598-023-30349-w |
| spellingShingle | Youzheng Dong Zhenyu Zhai Jihong Wang Zhen Xia Zirong Xia Bo Zhu Quanbing Dong Qing Li Juxiang Li Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation Scientific Reports |
| title | Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| title_full | Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| title_fullStr | Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| title_full_unstemmed | Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| title_short | Angiotensin receptor-neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| title_sort | angiotensin receptor neprilysin inhibitor delays progression from paroxysmal to persistent atrial fibrillation |
| url | https://doi.org/10.1038/s41598-023-30349-w |
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