54Treating underlying conditions improves quality of life in patients with persistent atrial fibrillation and heart failure - data from the RACE 3 study
Bibliographic record
Abstract
On behalf of: RACE 3 study group Funding Acknowledgements: Netherlands Heart Foundation, AstraZeneca, Bayer, Biotronik, Boehringer-Ingelheim, Boston Scientific, Medtronic, Sanofi-Aventis, St-Jude-Medical Introduction: Atrial fibrillation (AF) reduces quality of life (QoL). Purpose: We sought to evaluate the effect of treating underlying conditions on QoL in patients with early persistent AF and early mild to moderate heart failure (HF). Methods: We studied QoL in 230 patients with early-persistent AF and early mild to moderate HF included in the randomized, multicenter, prospective Routine versus Aggressive Risk Factor Driven Upstream Rhythm Control for Prevention of Early Atrial Fibrillation in Heart Failure (RACE 3) study. The intervention group received 4 therapies on top of conventional care: 1) mineralocorticoid receptor antagonists, 2) statins, 3) angiotensin converting enzyme inhibitors and/or receptor blockers, and 4) cardiac rehabilitation including physical activity, dietary restrictions, and counseling. The 36-Item Short Form Health Survey (SF-36), Toronto AF severity scale (AFSS) and EHRA class were used to assess QoL and AF related symptoms on baseline and 1 year follow up (FU). Analyses were performed on an intention to treat basis. Results: Age was 65±9 years, 180 (78%) were men, median AF history was 3 (2-6) months and median HF duration 2 (1-4) was months. Hypertension was present in 139 (60%), diabetes in 22 (10%), coronary artery disease in 30 (13%). Left ventricular ejection fraction (LVEF) was 52 (43-60)%, atrial volume 38 (31-48) ml/m2. At baseline clinical characteristics were comparable in the intervention (n=114) and conventional group (n=116). At baseline the 8 SF-36 domains were comparable between both groups. At 1-year FU, all 8 SF-36 categories improved in the intervention, compared to 4 out of 8 categories in the conventional group. Mean change between baseline and 1 year in physical functioning (Δ11.6±19.2 vs Δ5.8±22.5, p=0.015), physical role limitations (Δ32.8±41.5 vs 16.5±45.0, p=0.011), and general health (Δ8.3±16.1 vs Δ–0.3 ±17.2, p<0.001) was significantly higher in the upstream group. No differences in AFSS were present at baseline between groups. In the AFSS, dyspnea in rest improved significantly more in the intervention group (Δ–0.8±1.3 vs Δ–0.4±1.2, p=0.018). At baseline EHRA class was 2.01±0.51 in the intervention vs 2.05±0.51 (p=0.520) in the conventional group, and 1.31±0.52 vs 1.54±0.64 (p=0.003) at 1 year FU. Conclusion: A strategy aiming to treat underlying conditions improves physical functioning, physical role limitations and general health significantly more compared to conventional therapy in patients with persistent atrial fibrillation and mild to moderate heart failure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".