1.1 Background
Atrial fibrillation (AF) is responsible for significantly increased morbidity and mortality, worsened New York Heart Association (NYHA) functional class, and impaired quality of life in the general population [1]. For instance, data from the longitudinal population-based Framingham Heart Study suggest that AF is solely associated with a threefold to fivefold increased risk of stroke [2] and with an approximately twofold increased risk for mortality [3]. The ischemic strokes due to AF-related thromboembolic events are generally more severe than strokes due to other reasons and prone to worse prognosis [4]. Observational studies also suggest that incident AF is linked to acute heart failure and chronic heart failure decompensations [5, 6]. In a case-control study, Savelieva et al. assessed the quality of life in 154 patients with …show more content…
The specific aims of this study were as follows:
Specific Aim 1. To characterize the study samples and utilization of RAAS inhibitors (i.e., the exposure/treatment of interest), BBs and CCBs (i.e., the two active control drugs) among Medicare beneficiaries with HTN (i.e., the target population) who filled prescriptions of one of the above study medications between January 1, 2007 and September 30, 2011.
Specific Aim 2. To assess the preventive effect of RAAS inhibitors against the occurrence of newly-documented AF as compared with BBs or CCBs.
Aim 2a. To compare the monotherapy of RAAS inhibitors with the monotherapy of BBs on the cause-specific hazard of developing newly-documented AF among Medicare beneficiaries with HTN.
Aim 2b. To compare the monotherapy of RAAS inhibitors with the monotherapy of BBs on the cause-specific hazard of all-cause death with no AF anytime during follow-up among Medicare beneficiaries with
Atrial fibrillation (AF) is responsible for significantly increased morbidity and mortality, worsened New York Heart Association (NYHA) functional class, and impaired quality of life in the general population [1]. For instance, data from the longitudinal population-based Framingham Heart Study suggest that AF is solely associated with a threefold to fivefold increased risk of stroke [2] and with an approximately twofold increased risk for mortality [3]. The ischemic strokes due to AF-related thromboembolic events are generally more severe than strokes due to other reasons and prone to worse prognosis [4]. Observational studies also suggest that incident AF is linked to acute heart failure and chronic heart failure decompensations [5, 6]. In a case-control study, Savelieva et al. assessed the quality of life in 154 patients with …show more content…
The specific aims of this study were as follows:
Specific Aim 1. To characterize the study samples and utilization of RAAS inhibitors (i.e., the exposure/treatment of interest), BBs and CCBs (i.e., the two active control drugs) among Medicare beneficiaries with HTN (i.e., the target population) who filled prescriptions of one of the above study medications between January 1, 2007 and September 30, 2011.
Specific Aim 2. To assess the preventive effect of RAAS inhibitors against the occurrence of newly-documented AF as compared with BBs or CCBs.
Aim 2a. To compare the monotherapy of RAAS inhibitors with the monotherapy of BBs on the cause-specific hazard of developing newly-documented AF among Medicare beneficiaries with HTN.
Aim 2b. To compare the monotherapy of RAAS inhibitors with the monotherapy of BBs on the cause-specific hazard of all-cause death with no AF anytime during follow-up among Medicare beneficiaries with