ORLANDO, Florida, November 15 - Results from the RecordAF registry (REgistry on Cardiac rhythm
disORDers assessing the control of Atrial Fibrillation), presented today at
the Scientific Sessions of the American Heart Association, show that in
recently diagnosed and actively treated patients with atrial fibrillation
(AF), a rhythm-control strategy provides better short term control of the
arrhythmia versus a rate-control strategy but does not translate into a
reduction in the occurrence of clinical events at 1 year. RecordAF also
confirmed that these patients suffer from a high rate of clinical events,
mainly cardiovascular (CV) hospitalisations.
(Logo: www.newscom.com/cgi-bin/prnh/20091115/366795-a )
(Logo: www.newscom.com/cgi-bin/prnh/20091115/366795-b )
(Logo: www.newscom.com/cgi-bin/prnh/20091115/366795-c )
(Logo: www.newscom.com/cgi-bin/prnh/20091115/366795-d )
RecordAF is the first international prospective, observational
survey established to help assess the global burden of atrial fibrillation by
investigating the way in which it is managed in "real world" clinical
cardiology settings, identifying best clinical practice, and shaping the
future management of the disease. 5,604 patients with recently diagnosed
atrial fibrillation (first diagnosed, paroxysmal or persistent) participated
in the RecordAF registry over 12 months, from Apr 2007 to Apr 2008.
"RecordAF shows that while a rhythm-control strategy achieves
superior therapeutic success in atrial fibrillation than a rate-control
strategy, there is no difference in the occurrence of clinical outcomes
between strategies," said Prof John Camm, St George's University, London, UK,
joint-lead investigator. "To truly optimise the management of atrial
fibrillation we need anti-arrhythmic drugs that improve both rhythm- and
rate-control and significantly reduce clinical events."
Atrial fibrillation is a potentially life-threatening disease
caused by an erratic electrical activity in the heart which worsens the
prognosis of patients with CV risk factors and increases the risk of
hospitalization, stroke, and mortality. [1],[2],[3],[4],[5]
RecordAF shows that a rhythm control strategy was the
preferred therapeutic option (55 percent) at the start of the study.
Therapeutic success (unchanged strategy; no adverse events; maintenance of
sinus rhythm or reduction of heart rate less than or equal to 80 beats per
minute) was 60 percent with a rhythm-control strategy compared to 47 percent
with a rate-control strategy. After one year, 54 percent of patients on
rate-control strategy had developed permanent atrial fibrillation compared
with 13 percent of patients in the rhythm-control strategy group.
In RecordAF, a high number of patients (18%) suffered a
clinical event of which 90% were CV hospitalizations. This highlights the
increased CV morbidity and mortality in the AF patient population. There was
no difference in the reduction of clinical events between patients on the
rhythm or rate control groups with 17% vs 18% of CV events respectively.
"A large scale registry such as RecordAF improves our
understanding of the impact of different therapeutic strategies on clinical
outcomes," said Prof Peter Kowey, Lankenau Hospital, Wynnewood, PA, USA,
joint-lead investigator. "We now know that rate-control is not an easier or
better treatment strategy than rhythm-control and there is a strong argument
to persist with a rhythm-control strategy."
"The incidence of atrial fibrillation is increasing rapidly
and becoming a greater burden on our practices. Research such as the RecordAF
registry provides a unique insight into factors that influence therapeutic
success. This is very important data for physicians who manage patients with
atrial fibrillation," said Prof. Eric Prystowsky, St Vincent Hospital and
Health Center Program, Indianapolis, IN, USA, joint-lead investigator.
RecordAF is supported by an unrestricted educational grant
from sanofi-aventis.
About RecordAF registry
The RecordAF survey recruited 5,604 patients with recent onset
atrial fibrillation from 21 countries spanning North and South America,
Europe and Asia (5,171 patients - 92.3 percent were evaluable after 12-month
follow-up). They were followed-up for a period of one year. The primary
outcomes of the study were therapeutic success and clinical outcomes
associated with rhythm- and rate-control strategies. Therapeutic success
required that therapeutic strategy was unchanged, without clinical events;
maintenance of sinus rhythm was required in the rhythm control group and
heart rate less than or equal to 80 beats per minute in the rate control
group.
532 physicians involved in the registry were randomly selected
from an initial representative and exhaustive global list of office- and
hospital-based cardiologists. Patients aged greater than or equal to 18 years
were considered for enrolment if they presented with AF or a history of AF,
diagnosed by standard electrocardiogram (ECG) or ECG Holter monitoring and
if they were eligible for pharmacological treatment by rhythm- or
rate-control agents. Three visits took place at baseline, 6 months (plus or
minus 2 months) -not mandatory- , and 12 months (plus or minus 3 months).
About atrial fibrillation
Atrial fibrillation is the most common cardiac arrhythmia and
affects nearly 7 million people in the European Union and the United
States.[1],[6] AF currently represents a major economic burden for society
and leads to potential life-threatening complications. AF increases the risk
of stroke up to five-fold4, worsens the prognosis of patients with CV risk
factors[1],[3], and doubles the risk of mortality[5] with significant burden
on patients, health care providers and payers. Hospitalizations for AF have
increased dramatically (two-to-three-fold) in recent years.[2],[7] AF
hospitalizations now represent a third of all hospitalizations for arrhythmia
and mortality in the US and Europe.[1] Seventy percent of the annual cost of
AF management in Europe is driven by hospital care and interventional
procedures.[8]
References
———————————
[1] Fuster V et al. ACC/AHA/ESC 2006 guidelines for the management of
patients with atrial fibrillation. European Heart Journal (2006) 27,
1979-2030.
[2] Wattigney WA, Mensah GA & Croft JB. Increasing trends in
hospitalization for atrial fibrillation in the US 1985 through 1999
Implications for primary prevention. Circulation. 2003;108:711-716.
[3] Dorian P et al. J Am Coll Cardiol. 2000;36:1303-1309
[4] Lloyd-Jones et al. Lifetime Risk for Development of Atrial
Fibrillation: The Framingham Heart Study. Circulation. 2004; 110:1042-1046.
[5] Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy
D. Impact of atrial fibrillation on the risk of death: the Framingham Heart
Study. Circulation 1998 Sep 8; 98(10):946-52.
[6] Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial
fibrillation in adults: national implications for rhythm management and
stroke prevention: the AnTicoagulation and Risk Factors in Atrial
Fibrillation (ATRIA) Study. JAMA 2001; 285:2370-5
[7] Wattigney WA, Circulation. 2003;108:711-716
[8] Ringborg A, Nieuwlaat R, Lindgren P, Jönsson B, Fidan D, Maggioni AP,
Lopez-Sendon J, Stepinska J, Cokkinos DV, Crijns HJ. Costs of atrial
fibrillation in five European countries: results from the Euro Heart Survey
on atrial fibrillation. Europace. 2008 Apr;10(4):403-11. Epub 2008 Mar 7.
For more information visit: www.recordaf.org
Press contact: Joanna Tubbs, Tel: +44-207-878-3107, joanna.tubbs at mslworldwide.com
Related Press Releases
ADVANCE Reveals New Insights in the Fight Against Severe Diabetes ComplicationsOctober 19th, 2009 MONTREAL - New results from ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation), the largest clinical trial ever performed in patients with type 2 diabetes worldwide, provide important insights into the therapeutic strategy to adopt for efficient and safe blood glucose control aimed at the reduction of severe diabetes complications.(1)
The new data from ADVANCE, presented today at the International Diabetes Federation (IDF) Congress, show that the efficacy and safety of intensive blood glucose control using gliclazide modified release (MR) (Diamicron MR)-based regimen is maintained across a broad range of patients in different clinical settings.(1)
ADVANCE demonstrated that intensive glucose control with a gliclazide MR-based treatment regimen in people with type 2 diabetes reduces the combined risk of microvascular and macrovascular events, primarily through reductions in the risk of diabetic nephropathy.(2)
"Intensive glucose control with a gliclazide MR-based regimen was effective in lowering HbA1C, irrespective of age, duration of diabetes, sex, body mass index, or HbA1C at study entry, and also irrespective of initial glucose lowering treatment," said ADVANCE Study Investigator Sophia Zoungas from The George Institute for International Health, Australia. "The gliclazide MR-based regimen was well-tolerated with very low rates of severe hypoglycemia and no weight gain."
ADVANCE showed a positive trend toward a reduction of major cardiovascular events in diabetes patients who received intensive glucose control.(2) This finding was supported in a recent collaborative meta-analysis of 4 trials of intensive glucose lowering, including ADVANCE and ACCORD, which demonstrated a significant 9% reduction in major cardiovascular events, primarily reflecting a 15% reduction in myocardial infarction.(3) On the basis of observational data, several national registers (including more than 70,000 patients with type 2 diabetes),have recently reported that glucose lowering regimens that included gliclazide were associated with lower risks of mortality compared to other therapeutic strategies.(4,5)
"ADVANCE is a huge reservoir of valuable clinical information," concluded ADVANCE Principal Investigator Professor John Chalmers from The George Institute for International Health, Australia.
Sanofi Aventis : Multaq(R) (dronedarone) Recommended for Approval in the European UnionSeptember 24th, 2009 PARIS - Sanofi-aventis (EURONEXT: SAN and NYSE: SNY) announced today that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA) has adopted a positive opinion recommending to grant a marketing authorization in the European Union for Multaq(R) (dronedarone - 400mg Tablets). The CHMP has recommended the approval of Multaq(R) in adult clinically stable patients with history of, or current non-permanent atrial fibrillation (AF) to prevent recurrence of AF or to lower ventricular rate.
Largest Registry to Date to Provide the First-Ever Picture of the Real Global Burden of Atrial Fibrillation (AF)August 29th, 2009 BARCELONA, Spain -
- Six-year GARFIELD Registry to prospectively follow 50,000 AF patients worldwide -
The Thrombosis Research Institute (TRI) - an affiliated institute of Queen Mary University of London - today announced the launch of GARFIELD (Global Anticoagulant Registry in the Field), an innovative research initiative to understand the burden of atrial fibrillation (AF) on a global scale. Atrial fibrillation is a common condition in which the two small upper chambers of the heart (the atria) quiver rather than beat rhythmically and can lead to life-threatening complications, including stroke.
Analysis of Edoxaban Phase II Data Provides Insight Into Reduced Bleeding Events Seen in Once-Daily DosingJuly 14th, 2009 BOSTON and EDISON, New Jersey -
-- Pharmacokinetic Analysis of Atrial Fibrillation Study May Explain Bleeding Rate Difference between Once-Daily and Twice-Daily Dosing Regimens with Same Total Exposure of Factor Xa Inhibitor --
A sub-analysis of a Phase IIb multinational study(1) with edoxaban(2) -- an investigational oral Factor Xa inhibitor - provides insights into why patients with non-valvular atrial fibrillation (AF) receiving edoxaban once daily (OD) experienced fewer bleeding events than patients given edoxaban twice a day (BID). The analysis finds that bleeding associated with edoxaban is most closely correlated with minimum concentration levels of the drug in the blood, and that these trough levels may best predict bleeding events, rather than total exposure or maximum concentration levels.
FDA Approves Multaq(R) for Patients With Atrial Fibrillation or Atrial FlutterJuly 1st, 2009 PARIS -
- Multaq(R) Approved to Reduce the Risk of Cardiovascular Hospitalization in Patients With Atrial Fibrillation or Atrial Flutter
- U.S Commercial Launch Planned for the Summer of 2009
Sanofi-aventis (EURONEXT: SAN and NYSE: SNY) announced today that the U.S. Food and Drug Administration (FDA) has approved Multaq(R) (dronedarone) 400 mg Tablets.
AF AWARE Cardiology Groups Call for Greater Awareness and Better Education on Atrial FibrillationJune 7th, 2009 LONDON - Survey Shows Many Doctors Find the Management of Atrial Fibrillation Difficult and Patients are Unaware of the Risks, Complexities and Treatment for This Most Common of Heart Rhythm Disorders
Four leading patient and medical associations announced today the formation of AF AWARE (Atrial Fibrillation AWareness And Risk Education), a joint initiative to highlight and address issues that contribute to the growing burden of atrial fibrillation (AF) worldwide. AF is a common yet under-recognised and poorly understood abnormal heart rhythm that is associated with poor quality of life, substantial numbers of hospitalisations, increased risk of severe and potentially fatal cardiovascular complications such as stroke, as well as death.
Advance in Bowel Cancer Test ResearchJune 4th, 2009 SYDNEY - Australian researchers have developed gene expression biomarkers which can accurately discriminate pre-cancerous and cancerous colorectal growths from non-cancerous controls. Being presented today at the Digestive Disease Week conference in Chicago, the preliminary findings are the result of a collaborative study - involving CSIRO, Flinders University and Australian healthcare company, Clinical Genomics Pty Ltd - designed to develop an improved screening/diagnostic test for detecting bowel cancer and significant pre-cancer lesions.
Definitive Outcomes of Radiofrequency Ablation for Barrett's Esophagus Using the HALO Ablation System Reported at the Digestive Disease Week Meeting for Gastroenterologists and Esophageal SurgeonsJune 2nd, 2009 SUNNYVALE, California - Radiofrequency ablation is durable after 2 years, compares favorably with endoscopic resection for advanced disease, and reduces the risk for cancer progression
Results from a number of clinical trials were presented during the Digestive Disease Week (DDW) in Chicago this week, revealing new outcomes data related to endoscopic radiofrequency ablation using the HALO ablation system for eradicating a pre-cancerous esophageal condition known as Barrett's esophagus. Among them, reports included durability outcomes from a randomized sham-controlled trial, safety and efficacy outcomes from a large U.S.
Dutch Consortium Builds Registry Framework for Care of Rare DiseasesApril 5th, 2009 LEIDEN, The Netherlands - The Dutch Orphan Disease Registry Consortium is set up in order to build a disease registry framework to collect information on rare diseases, encourage drug development and optimize patient care. The consortium focuses on inborn errors of metabolism as target group of diseases.
Edoxaban - Factor Xa Inhibitor Enters Phase III With Optimal DoseMarch 26th, 2009 MUNICH - Edoxaban (DU-176b) is a direct Factor Xa inhibitor and is developed to
prevent thromboembolic events such as stroke and pulmonary embolism. The
Phase II Edoxaban programme has been successfully completed for orthopaedic
and cardiological indications.
Related News
Big men 'at increased abnormal heart rhythm risk'April 4th, 2009 WASHINGTON - Older men who were big during their 20s are at an increased risk of suffering from atrial fibrillation, or abnormal heart rhythm, says a new study. According to the new research from the Sahlgrenska Academy, University of Gothenburg, Sweden, being big includes height and weight.
Merck, Portola Pharmaceuticals sign deal worth up to $420 million to develop anticlotting drugJuly 9th, 2009 Merck, Portola in $420M deal for anticlotting drugWHITEHOUSE STATION, N.J. — Merck & Co.
Novel discovery may offer improved therapies for inflammatory bowel diseaseJune 3rd, 2009 WASHINGTON - An international team of researchers has discovered an enzyme that plays a crucial role in inflammatory bowel disease (IBD). The researchers hope that the new finding could potentially lead to therapies to help those affected by ulcerative colitis and Crohn's disease, collectively referred to as IBD.
New drug shows promise to reduce stroke riskAugust 31st, 2009 LONDON - A new drug developed as an alternative to popular drug warfarin, also used as rat poison, has been found to significantly reduce stroke risk. Generally, patients at risk of stroke are given warfarin to prevent blood clotting, but the treatment is risky and requires regular monitoring.
Study shows experimental drug cuts stroke risk in patients with irregular heartbeatsAugust 30th, 2009 Study shows experimental drug cuts stroke riskBARCELONA, Spain — An experimental drug reduces the stroke risk in patients with irregular heartbeats by nearly four times, compared with the popular drug warfarin — but possibly at a cost, according to new research released Sunday. Patients taking the new drug dabigatran etexilate, made by German pharmaceutical Boehringer Ingelheim, also were slightly more likely to have heart attacks or stomach pain, according to the research presented at the European Society of Cardiology meeting in Barcelona.
Aspirin improves survival in women with heart diseaseMarch 16th, 2009 WASHINGTON - Researchers have come by additional evidence that aspirin seems to reduce the risk of death in women who have heart disease or have had a stroke. The new study also provides fresh insight into aspirin dosing for women, suggesting that a lower dose of aspirin (81 mg) is as effective as a higher dose (325 mg).
Calif. lawmakers lead successful effort in House to create US registry of convicted arsonistsSeptember 30th, 2009 House passes registry for convicted arsonistsWASHINGTON — The House has passed a bill sought by California lawmakers that would create a national registry of convicted arsonists. The House passed a similar bill two years ago, but the effort stalled in the Senate.
Even moderate CO2-reduction policies can save the world from catastropheOctober 3rd, 2009 WASHINGTON - A new analysis of climate risk has shown that even moderate carbon-reduction policies now can substantially lower the risk of future climate change. To illustrate the findings of their model, MIT (Massachusetts Institute of Technology) researchers created a pair of 'roulette wheels.'
This wheel depicts their estimate of the range of probability of potential global temperature change over the next 100 years if no policy change is enacted on curbing greenhouse gas emissions.
MakroCare announces workshop on Advanced GCP on May 15May 6th, 2009 HYDERABAD - MakroCare, a global clinical services firm, provides clinical research support to pharmaceutical, biotechnology, and medical device industries, is taking a lead in the training of professionals for the clinical research industry by providing series of informational through workshop and seminars. Advanced GCP workshop will be held at CHITRAMAYEE Auditorium, State Arts Gallery, Kavuri Hills, Madhapur, Hyderabad on May 15.
NGO to ask MPs on steps they took to control tuberculosisMarch 6th, 2009 NEW DELHI - An NGO, working for tuberculosis patients, has initiated a study to know steps taken by parliamentarians to control the disease in their constituencies. 'With nearly 1,000 people dying of tuberculosis everyday in India despite several high quality drugs and well established programmes, it become important to know what people's representatives are doing to control and spread awareness about it,' said Bobby John of the NGO Advocacy to Control TB Internationally (Action) Thursday.