working cost-effectiveness study: data sources: studies included as data sources
DISEASE INTERVENTION COMPARISON RESULTS
Cochrane Database Syst Rev. 2007;0(4):CD005049 Systematic Review, Cochrane Review
IN atrial fibrillation, rhythm control strategy The Use of
antiarrhythmic drugs, classes IA, IC, III
As Treatment, Chronic
Is worse Than
placebo or no treatment
To improve mortality: class IA drugs (quinidine, dysopiramide) increased mortality (NNH 109) and the rest did not modify it. All drugs increased adverse effects and pro-arrhythmia (but amiodarone).
Arch Intern Med. 2006 Apr 10;166(7):719-28 Systematic Review
IN atrial fibrillation, rhythm control strategy The Use of
antiarrhythmic drugs, classes IA, IC, III
As Treatment, Chronic
Is worse Than
placebo or no treatment
To reduce mortality, class IA drugs (quinidine, dysopiramide) increased mortality (NNH 109) and the rest did not modify it. All drugs increased adverse effects and pro-arrhythmia (but amiodarone).
JAMA. 2002 Nov 20;288(19):2441-8 Meta-Analysis
IN atrial fibrillation, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To decrease stroke (of any type): 2.4% per year with warfarin VS. 4.5% with aspirin. But modestly increased major bleeding: 2.2 VS. 1.3% per year. Overall all-cause mortality did not differ
Ann Intern Med. 2007 Jun 19;146(12):857-67 Systematic Review
IN atrial fibrillation, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To reduce stroke (any type) rates: by 60% warfarin VS by 20% reduction with aspirin. Increases in major extracranial hemorrhage <= 0.3% per year)
Arch Intern Med. 2006 Jun 26;166(12):1269-75 Systematic Review
IN stroke, ischemic, cerebral infarction, embolic, atrial fibrillation The Use of
standard dose and low dose vitamin K antagonists, warfarin, ximelagatran, antiplatelet drugs, aspirin
As Treatment, Chronic
Is better Than
placebo
To prevent stroke (all types): standard-dose warfarin could prevent 28 ischemic strokes at the expense of 11 major bleedings, aspirin prevent 16 strokes with 6 major bleedings.
J Am Coll Cardiol. 2003 Jan 15;41(2):255-62 Meta-Analysis
IN StudyID: Chevalier 2003, atrial fibrillation The Use of
amiodarone
As Treatment, Acute
Is better Than
placebo
To converting AF to sinus rhythm. No difference in trials comparing againts class Ic drugs
Ann Intern Med. 2003 Dec 16;139(12):1018-33 Review (Narrative)
IN StudyID: McNamara 2003, atrial fibrillation The Use of
diverse AAR, diverse interventions for cardioversion, for rate control
As Treatment, Acute
Is useful Than
placebo, or no treatment, or other drug
To control AF, or reduce stroke and other complications of AF
J Fam Pract 2000 Nov;49(11):1033-46 Meta-Analysis
IN StudyID: Miller 2000, atrial fibrillation, existing meta-analysis The Use of
diverse antiarrhythmic drugs
As -
Is better Than
placebo or rate control
To maintining sinus rhythm. Not data about mortality or adverse effects.
J Am Coll Cardiol. 1997 Sep;30(3):791-8 Meta-Analysis
IN StudyID: Vorperian 1997, antiarrhythmic drugs, amiodarone, adverse effects The Use of
amiodarone, low dose maintenace
As Treatment, Chronic
Is worse Than
placebo
To produce at 12 months more side effects: thyroid OR 4,2 ; thyroid OR 4,2 ; ocular OR 3,4 ; skin OR 2,5 ; bradycardic OR 2,2 ; neurologic OR 2,0. Treatment withdrawal: 23% in amiodarone, 15% placebo