医学
心房颤动
临床试验
临床实习
功效
心脏病学
临床终点
内科学
生活质量(医疗保健)
药品
临床疗效
心力衰竭
重症监护医学
心房颤动的处理
物理疗法
药理学
护理部
作者
James A. Reiffel,Gerald V. Naccarelli
标识
DOI:10.1016/j.amjmed.2022.02.019
摘要
Determining if a medication is effective should be easy: Either the condition is or is not improved. However, the truth is often more complex than that, including in the antiarrhythmic drug (AAD) management of atrial fibrillation. In clinical trials, AAD efficacy is usually determined by the time to first atrial fibrillation recurrence. Another AAD efficacy endpoint, in patients with cardiac implantable electrical devices, is a reduction of atrial fibrillation burden. Other cardiovascular outcomes have included hospitalization, heart failure, and cardiovascular or total mortality. In clinical practice AADs, for atrial fibrillation, are prescribed to reduce symptoms/improve quality of life, which usually correlate with reduced atrial fibrillation frequency, duration, and beneficial hemodynamic effects in certain patient subgroups. Time to first recurrence is not a reliable predictor of clinical efficacy endpoints in practice. This article presents a review for the practitioner of AAD efficacy endpoints in clinical trials versus those in clinical practice and why such differences are present.
科研通智能强力驱动
Strongly Powered by AbleSci AI