Evidence map›Paper›PMID 29401239›Full record

Trial reportEuropean heart journal2018

Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial.

Michiel Rienstra, Anne H Hobbelt, Marco Alings, Jan G P Tijssen, Marcelle D Smit, Johan Brügemann, Bastiaan Geelhoed, Robert G Tieleman, Hans L Hillege, Raymond Tukkie and 4 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European heart journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00877643 (Routine Versus Aggressive Upstream Rhythm Control for Prevention of Early Atrial Fibrillation in Heart Failure), which is not on this map. Cited by 128 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 6 pooled it
17.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00877643 nacompletednot on this map

Routine Versus Aggressive Upstream Rhythm Control for Prevention of Early Atrial Fibrillation in Heart Failure: RACE 3

TypeinterventionalSponsorI.C. Van GelderRan2009 to 2021Enrolled250ConditionsAtrial FibrillationArmsUpstream therapy, Conventional rhythm control
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 6 syntheses or guidelines pooled it, 302 citations in OpenAlex.

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  8. Long-term outcome of targeted therapy of underlying conditions in patients with early persistent atrial fibrillation and heart failure: data of the RACE 3 trial.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 · 2022
    Trial
  9. Rate control drugs differ in the prevention of progression of atrial fibrillation.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 · 2022
    Trial
  10. Antiarrhythmic drugs in patients with early persistent atrial fibrillation and heart failure: results of the RACE 3 study.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 · 2021
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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 1 country.

Michiel RienstraDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Anne H HobbeltDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Marco AlingsDepartment of Cardiology, Amphia Hospital, Breda, The Netherlands.
Jan G P TijssenDepartment of Cardiology, Academic Medical Centre - University of Amsterdam, Amsterdam, The Netherlands.
Marcelle D SmitDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Johan BrügemannDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Bastiaan GeelhoedDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Robert G TielemanDepartment of Cardiology, Martini Hospital, Groningen, The Netherlands.
Hans L HillegeDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Raymond TukkieDepartment of Cardiology, Spaarne Hospital, Haarlem, The Netherlands.
Dirk J Van VeldhuisenDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Harry J G M CrijnsDepartment of Cardiology, Maastricht University Medical Centre+, The Netherlands.
Isabelle C Van GelderDepartment of Cardiology, University of Groningen University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
RACE 3 Investigators
University of Groningen · NLUniversity Medical Center Groningen · NLMaastricht University · NLMartini Ziekenhuis · NLSpaarne Ziekenhuis · NLUniversity of Amsterdam · NLYulius · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Atrial fibrillation (AF) is a progressive disease. Targeted therapy of underlying conditions refers to interventions aiming to modify risk factors in order to prevent AF. We hypothesised that targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent AF. Methods and results: We randomized patients with early persistent AF and mild-to-moderate heart failure (HF) to targeted therapy of underlying conditions or conventional therapy. Both groups received causal treatment of AF and HF, and rhythm control therapy. In the intervention group, on top of that, four therapies were started: (i) mineralocorticoid receptor antagonists (MRAs), (ii) statins, (iii) angiotensin converting enzyme inhibitors and/or receptor blockers, and (iv) cardiac rehabilitation including physical activity, dietary restrictions, and counselling. The primary endpoint was sinus rhythm at 1 year during 7 days of Holter monitoring. Of 245 patients, 119 were randomized to targeted and 126 to conventional therapy. The intervention led to a contrast in MRA (101 [85%] vs. 5 [4%] patients, P < 0.001) and statin use (111 [93%] vs. 61 [48%], P < 0.001). Angiotensin converting enzyme inhibitors/angiotensin receptor blockers were not different. Cardiac rehabilitation was completed in 109 (92%) patients. Underlying conditions were more successfully treated in the intervention group. At 1 year, sinus rhythm was present in 89 (75%) patients in the intervention vs. 79 (63%) in the conventional group (odds ratio 1.765, lower limit of 95% confidence interval 1.021, P = 0.042). Conclusions: RACE 3 confirms that targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent AF. Trial Registration number: Clinicaltrials.gov NCT00877643.

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsAtrial FibrillationCounselingDiet, HealthyExercise TherapyFemaleHeart FailureHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMineralocorticoid Receptor AntagonistsRisk Reduction BehaviorAngiotensin-Converting Enzyme InhibitorsHydroxymethylglutaryl-CoA Reductase InhibitorsMineralocorticoid Receptor Antagonists

Identifiers

PMID29401239
OpenAlexW2789203914

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.