Am J Cardiol. 2020 Aug 27:S0002-9149(20)30883-3. doi: 10.1016/j.amjcard.2020.08.026. Online ahead of print.
The antiarrhythmic drug dronedarone was designed to reduce the extra-cardiac adverse effects associated with amiodarone use in treatment of patients with atrial fibrillation / atrial flutter (AF/AFL). This epidemiological study used a retrospective cohort design to compare risk of cardiovascular-related hospitalizations and death among AF/AFL patients treated with dronedarone versus other antiarrhythmic drugs (AADs). AF/AFL patients with incident dronedarone fills were matched by propensity score (PS) to incident users of other AADs. The primary study outcome was hospitalization for cardiovascular (CV) causes within 24 months after the first study drug fill. A secondary composite outcome comprised hospitalization for CV causes or all-cause mortality during follow-up. Among the AF/AFL patient cohort meeting eligibility criteria, 6964 incident users of dronedarone and 25 607 incident users of other AADs were identified. The PS-matched cohort comprised 6349 Dronedarone users (91.2% of all eligible) and 12 698 Other AAD users. Dronedarone patients had a significantly lower risk of hospitalization for a CV event compared to Other AAD users (HR=0.87; 95% CI=0.79-0.96). This was consistent with results for the composite outcome (HR=0.86; 95% CI=0.78-0.95). In conclusion, AF/AFL patients initiated on dronedarone versus other AADs had significantly lower risk of CV hospitalizations as well as the composite CV hospitalization / death from any cause.