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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 林珍芳 | |
dc.contributor.author | Yi-Jung Wu | en |
dc.contributor.author | 吳依蓉 | zh_TW |
dc.date.accessioned | 2021-06-17T02:48:46Z | - |
dc.date.available | 2022-09-13 | |
dc.date.copyright | 2017-09-13 | |
dc.date.issued | 2017 | |
dc.date.submitted | 2017-08-15 | |
dc.identifier.citation | 1. Chamberlain AM, Redfield MM, Alonso A, Weston SA, Roger VL. Atrial fibrillation and mortality in heart failure: a community study. Circulation. Heart failure. 2011;4(6):740-746.
2. Anter E, Jessup M, Callans DJ. Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation. 2009;119(18):2516-2525. 3. Cleland JG, Swedberg K, Follath F, et al. The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. European heart journal. 2003;24(5):442-463. 4. Nieuwlaat R, Capucci A, Camm AJ, et al. Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. European heart journal. 2005;26(22):2422-2434. 5. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. The New England journal of medicine. 1996;334(21):1349-1355. 6. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. The New England journal of medicine. 2001;344(22):1651-1658. 7. Packer M, Fowler MB, Roecker EB, et al. Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation. 2002;106(17):2194-2199. 8. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet (London, England). 1999;353(9169):2001-2007. 9. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet (London, England). 1999;353(9146):9-13. 10. Turakhia MP, Santangeli P, Winkelmayer WC, et al. Increased mortality associated with digoxin in contemporary patients with atrial fibrillation: findings from the TREAT-AF study. Journal of the American College of Cardiology. 2014;64(7):660-668. 11. Gillis AM, Verma A, Talajic M, Nattel S, Dorian P. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: rate and rhythm management. The Canadian journal of cardiology. 2011;27(1):47-59. 12. Marazzi G, Iellamo F, Volterrani M, et al. Comparison of effectiveness of carvedilol versus bisoprolol for prevention of postdischarge atrial fibrillation after coronary artery bypass grafting in patients with heart failure. The American journal of cardiology. 2011;107(2):215-219. 13. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837-847. 14. Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(7):e257-354. 15. Psaty BM, Manolio TA, Kuller LH, et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997;96(7):2455-2461. 16. 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(18):2370-2375. 17. Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. Jama. 1994;271(11):840-844. 18. Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). The American journal of cardiology. 1994;74(3):236-241. 19. Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. Journal of the American College of Cardiology. 2014;63(12):1123-1133. 20. Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. Jama. 2003;289(2):194-202. 21. Mosterd A, Hoes AW, de Bruyne MC, et al. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study. European heart journal. 1999;20(6):447-455. 22. Roger VL, Weston SA, Redfield MM, et al. Trends in heart failure incidence and survival in a community-based population. Jama. 2004;292(3):344-350. 23. Levy D, Kenchaiah S, Larson MG, et al. Long-term trends in the incidence of and survival with heart failure. The New England journal of medicine. 2002;347(18):1397-1402. 24. Senni M, Tribouilloy CM, Rodeheffer RJ, et al. Congestive heart failure in the community: trends in incidence and survival in a 10-year period. Archives of internal medicine. 1999;159(1):29-34. 25. Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107(23):2920-2925. 26. Dries DL, Exner DV, Gersh BJ, Domanski MJ, Waclawiw MA, Stevenson LW. Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Studies of Left Ventricular Dysfunction. Journal of the American College of Cardiology. 1998;32(3):695-703. 27. Olsson LG, Swedberg K, Ducharme A, et al. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) program. Journal of the American College of Cardiology. 2006;47(10):1997-2004. 28. Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation. 1999;100(1):87-95. 29. Cha TJ, Ehrlich JR, Zhang L, et al. Dissociation between ionic remodeling and ability to sustain atrial fibrillation during recovery from experimental congestive heart failure. Circulation. 2004;109(3):412-418. 30. Takeuchi S, Akita T, Takagishi Y, et al. Disorganization of gap junction distribution in dilated atria of patients with chronic atrial fibrillation. Circulation journal : official journal of the Japanese Circulation Society. 2006;70(5):575-582. 31. Sridhar A, Nishijima Y, Terentyev D, et al. Chronic heart failure and the substrate for atrial fibrillation. Cardiovascular research. 2009;84(2):227-236. 32. Schneider MP, Hua TA, Bohm M, Wachtell K, Kjeldsen SE, Schmieder RE. Prevention of atrial fibrillation by Renin-Angiotensin system inhibition a meta-analysis. Journal of the American College of Cardiology. 2010;55(21):2299-2307. 33. Ben Morrison T, Jared Bunch T, Gersh BJ. Pathophysiology of concomitant atrial fibrillation and heart failure: implications for management. Nature clinical practice. Cardiovascular medicine. 2009;6(1):46-56. 34. Pozzoli M, Cioffi G, Traversi E, Pinna GD, Cobelli F, Tavazzi L. Predictors of primary atrial fibrillation and concomitant clinical and hemodynamic changes in patients with chronic heart failure: a prospective study in 344 patients with baseline sinus rhythm. Journal of the American College of Cardiology. 1998;32(1):197-204. 35. Swedberg K, Olsson LG, Charlesworth A, et al. Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET. European heart journal. 2005;26(13):1303-1308. 36. Ahmed A, Perry GJ. Incident atrial fibrillation and mortality in older adults with heart failure. European journal of heart failure. 2005;7(7):1118-1121. 37. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke; a journal of cerebral circulation. 1991;22(8):983-988. 38. Lip GY. Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why? European heart journal. 2013;34(14):1041-1049. 39. Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ. Epidemiology and natural history of atrial fibrillation: clinical implications. Journal of the American College of Cardiology. 2001;37(2):371-378. 40. 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;98(10):946-952. 41. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Archives of internal medicine. 1994;154(13):1449-1457. 42. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. The American journal of cardiology. 1998;82(8a):2n-9n. 43. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-2104. 44. Lip GY, Skjoth F, Nielsen PB, Larsen TB. Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score. A comprehensive net clinical benefit analysis for warfarin, aspirin, or no therapy. Thrombosis and haemostasis. 2015;114(4):826-834. 45. Chao TF, Liu CJ, Wang KL, et al. Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation? Journal of the American College of Cardiology. 2015;65(7):635-642. 46. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. The New England journal of medicine. 2009;361(12):1139-1151. 47. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. The New England journal of medicine. 2011;365(10):883-891. 48. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. The New England journal of medicine. 2011;365(11):981-992. 49. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. The New England journal of medicine. 2013;369(22):2093-2104. 50. Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. The New England journal of medicine. 2002;347(23):1825-1833. 51. Hohnloser SH, Kuck KH. Randomized trial of rhythm or rate control in atrial fibrillation: the Pharmacological Intervention in Atrial Fibrillation Trial (PIAF). European heart journal. 2001;22(10):801-802. 52. Carlsson J, Miketic S, Windeler J, et al. Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. Journal of the American College of Cardiology. 2003;41(10):1690-1696. 53. Van Gelder IC, Hagens VE, Bosker HA, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. The New England journal of medicine. 2002;347(23):1834-1840. 54. The effect of digoxin on mortality and morbidity in patients with heart failure. The New England journal of medicine. 1997;336(8):525-533. 55. Goldstein RE, Boccuzzi SJ, Cruess D, Nattel S. Diltiazem increases late-onset congestive heart failure in postinfarction patients with early reduction in ejection fraction. The Adverse Experience Committee; and the Multicenter Diltiazem Postinfarction Research Group. Circulation. 1991;83(1):52-60. 56. Olshansky B, Rosenfeld LE, Warner AL, et al. The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study: approaches to control rate in atrial fibrillation. Journal of the American College of Cardiology. 2004;43(7):1201-1208. 57. Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. European heart journal. 2012;33(21):2719-2747. 58. Cadrin-Tourigny J, Wyse DG, Roy D, et al. Efficacy of amiodarone in patients with atrial fibrillation with and without left ventricular dysfunction: a pooled analysis of AFFIRM and AF-CHF trials. Journal of cardiovascular electrophysiology. 2014;25(12):1306-1313. 59. Singla S, Karam P, Deshmukh AJ, Mehta J, Paydak H. Review of contemporary antiarrhythmic drug therapy for maintenance of sinus rhythm in atrial fibrillation. Journal of cardiovascular pharmacology and therapeutics. 2012;17(1):12-20. 60. Su VY, Hu YW, Chou KT, et al. Amiodarone and the risk of cancer: a nationwide population-based study. Cancer. 2013;119(9):1699-1705. 61. Waldo AL, Camm AJ, deRuyter H, et al. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. Lancet (London, England). 1996;348(9019):7-12. 62. Le Heuzey JY, De Ferrari GM, Radzik D, Santini M, Zhu J, Davy JM. A short-term, randomized, double-blind, parallel-group study to evaluate the efficacy and safety of dronedarone versus amiodarone in patients with persistent atrial fibrillation: the DIONYSOS study. Journal of cardiovascular electrophysiology. 2010;21(6):597-605. 63. Kober L, Torp-Pedersen C, McMurray JJ, et al. Increased mortality after dronedarone therapy for severe heart failure. The New England journal of medicine. 2008;358(25):2678-2687. 64. Connolly SJ, Camm AJ, Halperin JL, et al. Dronedarone in high-risk permanent atrial fibrillation. The New England journal of medicine. 2011;365(24):2268-2276. 65. Curtis AB, Worley SJ, Adamson PB, et al. Biventricular pacing for atrioventricular block and systolic dysfunction. The New England journal of medicine. 2013;368(17):1585-1593. 66. Khan AR, Khan S, Sheikh MA, Khuder S, Grubb B, Moukarbel GV. Catheter ablation and antiarrhythmic drug therapy as first- or second-line therapy in the management of atrial fibrillation: systematic review and meta-analysis. Circulation. Arrhythmia and electrophysiology. 2014;7(5):853-860. 67. Ganesan AN, Shipp NJ, Brooks AG, et al. Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis. Journal of the American Heart Association. 2013;2(2):e004549. 68. Gupta A, Perera T, Ganesan A, et al. Complications of catheter ablation of atrial fibrillation: a systematic review. Circulation. Arrhythmia and electrophysiology. 2013;6(6):1082-1088. 69. Maan A, Shaikh AY, Mansour M, Ruskin JN, Heist EK. Complications from catheter ablation of atrial fibrillation: a systematic review. Critical pathways in cardiology. 2011;10(2):76-83. 70. Anselmino M, Matta M, D'Ascenzo F, et al. Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis. Circulation. Arrhythmia and electrophysiology. 2014;7(6):1011-1018. 71. Gentlesk PJ, Sauer WH, Gerstenfeld EP, et al. Reversal of left ventricular dysfunction following ablation of atrial fibrillation. Journal of cardiovascular electrophysiology. 2007;18(1):9-14. 72. Chen MS, Marrouche NF, Khaykin Y, et al. Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. Journal of the American College of Cardiology. 2004;43(6):1004-1009. 73. Efremidis M, Sideris A, Xydonas S, et al. Ablation of atrial fibrillation in patients with heart failure: reversal of atrial and ventricular remodelling. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese. 2008;49(1):19-25. 74. Khan MN, Jais P, Cummings J, et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure. The New England journal of medicine. 2008;359(17):1778-1785. 75. Lutomsky BA, Rostock T, Koops A, et al. Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2008;10(5):593-599. 76. Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet (London, England). 2009;374(9689):534-542. 77. Reddy VY, Sievert H, Halperin J, et al. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. Jama. 2014;312(19):1988-1998. 78. Holmes DR, Jr., Doshi SK, Kar S, et al. Left Atrial Appendage Closure as an Alternative to Warfarin for Stroke Prevention in Atrial Fibrillation: A Patient-Level Meta-Analysis. Journal of the American College of Cardiology. 2015;65(24):2614-2623. 79. Rienstra M, Damman K, Mulder BA, Van Gelder IC, McMurray JJ, Van Veldhuisen DJ. Beta-blockers and outcome in heart failure and atrial fibrillation: a meta-analysis. JACC. Heart failure. 2013;1(1):21-28. 80. Li SJ, Sartipy U, Lund LH, et al. Prognostic Significance of Resting Heart Rate and Use of beta-Blockers in Atrial Fibrillation and Sinus Rhythm in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Swedish Heart Failure Registry. Circulation. Heart failure. 2015;8(5):871-879. 81. Nielsen PB, Larsen TB, Gorst-Rasmussen A, Skjoth F, Lip GY. beta-Blockers in Atrial Fibrillation Patients With or Without Heart Failure: Association With Mortality in a Nationwide Cohort Study. Circulation. Heart failure. 2016;9(2):e002597. 82. Mareev Y, Cleland JG. Should beta-blockers be used in patients with heart failure and atrial fibrillation? Clinical therapeutics. 2015;37(10):2215-2224. 83. Poole-Wilson PA, Swedberg K, Cleland JG, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet (London, England). 2003;362(9377):7-13. 84. Konishi M, Haraguchi G, Kimura S, et al. Comparative effects of carvedilol vs bisoprolol for severe congestive heart failure. Circulation journal : official journal of the Japanese Circulation Society. 2010;74(6):1127-1134. 85. Su VY, Chang YS, Hu YW, et al. Carvedilol, Bisoprolol, and Metoprolol Use in Patients With Coexistent Heart Failure and Chronic Obstructive Pulmonary Disease. Medicine. 2016;95(5):e2427. 86. Chao TF, Liu CJ, Tuan TC, et al. Rate-control treatment and mortality in atrial fibrillation. Circulation. 2015;132(17):1604-1612. 87. Ishiguro H, Ikeda T, Abe A, et al. Antiarrhythmic effect of bisoprolol, a highly selective beta1-blocker, in patients with paroxysmal atrial fibrillation. International heart journal. 2008;49(3):281-293. 88. Nishio M, Sakata Y, Mano T, et al. Beneficial effects of bisoprolol on the survival of hypertensive diastolic heart failure model rats. European journal of heart failure. 2008;10(5):446-453. 89. Mulder BA, Van Veldhuisen DJ, Crijns HJ, et al. Lenient vs. strict rate control in patients with atrial fibrillation and heart failure: a post-hoc analysis of the RACE II study. European journal of heart failure. 2013;15(11):1311-1318. 90. Ignjatovic V, Pavlovic S, Miloradovic V, et al. Influence of Different beta-Blockers on Platelet Aggregation in Patients With Coronary Artery Disease on Dual Antiplatelet Therapy. Journal of cardiovascular pharmacology and therapeutics. 2016;21(1):44-52. 91. Micromedex® 2.0. Truven Health Analytics, Greenwood Village, Colorado, USA; electronic version:http://www.micromedexsolutions.com/. Accessed Jun 14 2016. 92. MedicinesComplete. London: Pharmaceutical Press; online:http://www.medicinescomplete.com/. Accessed Jun 14, 2016. 93. Leong-Sit P, Tang AS. Atrial fibrillation and heart failure: a bad combination. Current opinion in cardiology. 2015;30(2):161-167. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/69043 | - |
dc.description.abstract | 研究背景:
研究顯示部分beta blocker(BB)的使用能有效改善心臟衰竭(HF: heart failure)病人的存活率。同時,BB在心房顫動(AF: atrial fibrillation)病人的心速控制上亦佔有重要的地位。但是目前對於不同的BB在心房顫動併有心衰竭病人上具有的治療效果仍未有充分的探究。 研究目的: 針對使用不同BB的AF病人進行效果評估。並且進一步分析病人共病HF與否於BB使用的效果是否有所差異。 研究方法: 本研究為回溯性世代研究(retrospective cohort study),以2005-2011年的臺灣健康保險資料庫做為資料來源,篩選AF病人並依病人之前是否有HF紀錄做分組。之後再依病人所使用之BB做分組並挑選出使用bisoprolol、carvedilol以及metoprolol的病人做為主要研究族群。為了減少選擇性偏差,因此本研究利用傾向分數(propensity score)進行比較組間的配對,建構類似隨機分派對照實驗(randomized controlled trial),再以Cox proportional hazards regression model進行結果分析。 研究結果 在AF病人中,使用carvedilol的病人相較於使用bisoprolol的病人,有統計上顯著較高的因心血管疾病而再入院的風險。(HR 1.12; 95% CI 1.03 to 1.22; P=0.0062)。而此結果在AF未併有HF的病人上同樣顯著(HR 1.19; 95% CI 1.02 to 1.39; P=0.0242)。但在AF併有HF的病人上雖趨勢相同但並不顯著(HR 1.02; 95% CI 0.92 to 1.13; P=0.6998)。 結論 於AF病人使用carvedilol可能使病人較使用bisoprolol有較高的因心血管疾病再入院的風險。顯示不同的BB可能有不同的效果且此效果的顯著與否會隨著病人的HF共病而有所不同。 | zh_TW |
dc.description.abstract | Background
It has been proven that the usage beta-blocker (BB) can improve the mortality of heart failure (HF) patients. Meanwhile, BB plays a vital role in rate control of atrial fibrillation (AF) patients. Nevertheless, there hasn’t sufficient investigation toward the effects of individual BB on AF patients combined with HF. Purpose To assess the effects for AF patients who used different BB. In addition, examing whether HF comorbidity will affect the results is the other aim. Methods This study is a retrospective cohort study based on National Health Insurance Research Database (NHIRD) from 2005 to 2011. AF patients are included and divided to with HF group and without HF group. The further classification is based on records of BB usage. Patients used bisoprolol, carvedilol and metoprolol are the main population this study focus on. To reduce selection bias, propensity score is applied to match comparison group. The results are assessed after constructing groups similar to randomized controlled trial. Results Compared carvedilol with bisoprolol, the application of carvedilol shows higher risk of re-hospitalization of cardiovascular events in AF patients (HR 1.12; 95% CI 1.03 to 1.22; P=0.0062). This result is similar in the subgroup which AF patients without HF(HR 1.19; 95% CI 1.02 to 1.39; P=0.0242). Nonetheless, in AF patients combined with HF, the difference isn’t significant (HR 1.02; 95% CI 0.92 to 1.13; P=0.6998). Conclusion The effects of BB may be varied from one to another. Patients applied bisoprolol seems to have lower risk on the happening of cardiovascular re-hospitalization compared with patients used carvedilol in AF patients. This results may differ because of comorbidity of HF. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T02:48:46Z (GMT). No. of bitstreams: 1 ntu-106-R03423015-1.pdf: 1287552 bytes, checksum: e47a2b06f4d1679088e0f078bbbaadfc (MD5) Previous issue date: 2017 | en |
dc.description.tableofcontents | 致謝 I
中文摘要 II Abstract IV 目錄 VI 圖目錄 X 表目錄 XI 壹、 前言 1 一、 研究背景與現況 1 二、 研究目的 2 三、 研究重要性 2 貳、 疾病簡介 3 一、 流行病學 3 二、 病理機轉 4 三、 危險因子 4 四、 臨床影響 5 參、 疾病治療 6 一、 中風預防 6 二、 藥物治療 7 (一) 心速控制 7 (二) 心律控制 9 三、 非藥物治療 10 (一) 直流電極復律術(DCC:direct-current cardioversion) 10 (二) 心臟節律器(pacemaker) 10 (三) 經導管灼燒術(catheter ablation) 11 (四) 左心耳封堵手術(LAAC:Left Atrial Appendage Closure) 11 肆、 文獻回顧 12 一、 乙型阻斷劑在共病AF和HF上的效果 12 二、 乙型阻斷劑比較 13 (一) 族群:HF病人 13 (二) 族群:併有慢性阻塞性肺病的HF病人 14 (三) 族群:冠狀動脈繞道手術後的HF病人 14 伍、 研究目的 15 陸、 研究方法 15 一、 研究設計 15 二、 資料來源 15 三、 研究對象 16 (一) 納入條件 16 (二) 排除條件 17 四、 基本資料 17 (一) 分組依據 17 (二) 研究期間 18 (三) 研究終點 18 (四) 共病症 18 (五) CHA2DS2-VASc score 18 (六) 共藥 19 五、 統計分析 19 (一) 各研究分組背景資料分析 19 (二) 配對 19 (三) 回歸分析 20 (四) 顯著差異 20 柒、 結果 21 一、 主要族群分析 21 (一) 新診斷AF且有BB使用紀錄族群 21 (二) 各BB使用情形 21 (三) 族群基本特性 22 (四) 主要BB使用族群基本特性 22 (五) BB各組利用propensity score配對後結果及其分析 23 (六) BB的使用與研究終點間之關係 23 二、 次族群分析—併有HF之病人 24 (一) 新診斷AF、有BB使用紀錄且有HF病史的族群 24 (二) 各BB使用情形 24 (三) 主要BB使用族群基本特性 24 (四) BB各組利用propensity score配對後結果及其分析 25 (五) BB的使用與研究終點間之關係 25 三、 次族群分析—未併有HF之病人 26 (一) 新診斷AF、有BB使用紀錄但未併有HF病史的族群 26 (二) 各BB使用情形 26 (三) 主要BB使用族群基本特性 26 (四) BB各組利用propensity score配對後結果及其分析 27 (五) BB的使用與研究終點間之關係 27 四、 次族群分析—未併有氣喘之病人 28 捌、 討論 29 一、 BB藥物治療效果 29 二、 共病對BB藥物使用效果之影響 30 (一) HF 30 (二) 氣喘 30 三、 研究限制 31 四、 研究優點 32 玖、 結論與未來方向 33 壹拾、 圖 34 圖 一 研究族群篩選流程圖 34 壹拾壹、 表 35 壹拾貳、 參考文獻 78 | |
dc.language.iso | zh-TW | |
dc.title | 乙型阻斷劑於併有心房顫動和心臟衰竭病人效果比較 | zh_TW |
dc.title | Beta-Blockers in Atrial Fibrillation Patients with Heart Failure | en |
dc.type | Thesis | |
dc.date.schoolyear | 105-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 簡國龍,林俊立 | |
dc.subject.keyword | 心房顫動,心衰竭,乙型阻斷劑, | zh_TW |
dc.subject.keyword | atrial fibrillation,heart failure,β-blocker, | en |
dc.relation.page | 87 | |
dc.identifier.doi | 10.6342/NTU201603624 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2017-08-16 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 藥學研究所 | zh_TW |
顯示於系所單位: | 藥學系 |
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