Evidence map›Paper›PMID 35293087›Full record

ArticleEuropean journal of heart failure2022

Dronedarone for the treatment of atrial fibrillation with concomitant heart failure with preserved and mildly reduced ejection fraction: a post-hoc analysis of the ATHENA trial.

Muthiah Vaduganathan, Jonathan P Piccini, A John Camm, Harry J G M Crijns, Stefan D Anker, Javed Butler, John Stewart, Rogelio Braceras, Alessandro P A Albuquerque, Mattias Wieloch and 1 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
4.9field-weighted citation impact, top 4% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 31 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Article
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  6. Practical compendium of antiarrhythmic drugs: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology.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 · 2025
    Review
  7. Safety and efficacy of amiodarone and dronedarone for early rhythm control in EAST-AFNET 4.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Article
  8. 2024 update in heart failure.ESC heart failure · 2025
    Review
  9. Towards a phenotype profiling of the patients with heart failure and preserved ejection fraction.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  10. Review
  11. Article
  12. Review
  13. Review
  14. Review
  15. Article
  16. Cardiomyocyte Targeting Peptide to Deliver Amiodarone.bioRxiv : the preprint server for biology · 2023
    Article
  17. Article
  18. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 10 institutions in 7 countries.

Muthiah VaduganathanDivision of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Jonathan P PicciniDuke University Medical Center and the Duke Clinical Research Institute, Durham, NC, USA.
A John CammCardiology Clinical Academic Group Molecular & Clinical Sciences Institute, St George's University of London, London, UK.
Harry J G M CrijnsMaastricht University Medical Center, Maastricht, The Netherlands.
Stefan D AnkerDepartment of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Berlin, Germany.
Javed ButlerDepartment of Medicine, University of Mississippi, Jackson, MS, USA.
John StewartSanofi, Laval, Quebec, Canada.
Rogelio BracerasSanofi, Bridgewater, NJ, USA.
Alessandro P A AlbuquerqueSanofi, Bridgewater, NJ, USA.
Mattias WielochSanofi, Paris, France.
Stefan H HohnloserDivision of Clinical Electrophysiology, Department of Cardiology, J. W. Goethe University, Frankfurt, Germany.
Sanofi (United States) · USCharité - Universitätsmedizin Berlin · DEDuke Medical Center · USGoethe University Frankfurt · DEHarvard University · USMaastricht University · NLSanofi (Canada) · CASanofi (France) · FRSt George's, University of London · GBUniversity of Mississippi · US

Funding

Neurocognition and Greater Maintenance of Sinus Rhythm in AF (NOGGIN AF)R01AG074185 · NIA · DUKE UNIVERSITY · PI MATHEW, JOSEPH P, PICCINI, JONATHAN PAUL · 2021 to 2025
$3.7M
MAESTRO-PAF for Major Adverse Events and Stroke in Paroxysmal Atrial FibrillationR01HL128595 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI CHENG, ALAN, GUALLAR, ELISEO · 2016 to 2019
$3.1M
NHLBI NIH HHS R01 HL128595NIA NIH HHS R01 AG074185
6 · The paper itself

Abstract

aimsLimited therapeutic options are available for the management of atrial fibrillation/flutter (AF/AFL) with concomitant heart failure (HF) with preserved (HFpEF) and mildly reduced ejection fraction (HFmrEF). Dronedarone reduces the risk of cardiovascular events in patients with AF, but sparse data are available examining its role in patients with AF complicated by HFpEF and HFmrEF. METHODS AND

resultsATHENA was an international, multicentre trial that randomized 4628 patients with paroxysmal or persistent AF/AFL and cardiovascular risk factors to dronedarone 400 mg twice daily versus placebo. We evaluated patients with (i) symptomatic HFpEF and HFmrEF (defined as left ventricular ejection fraction [LVEF] >40%, evidence of structural heart disease, and New York Heart Association class II/III or diuretic use), (ii) HF with reduced ejection fraction (HFrEF) or left ventricular dysfunction (LVEF ≤40%), and (iii) those without HF. We assessed effects of dronedarone versus placebo on death or cardiovascular hospitalization (primary endpoint), other key efficacy endpoints, and safety. Overall, 534 (12%) had HFpEF or HFmrEF, 422 (9%) had HFrEF or left ventricular dysfunction, and 3672 (79%) did not have HF. Patients with HFpEF and HFmrEF had a mean age of 73 ± 9 years, 37% were women, and had a mean LVEF of 57 ± 9%. Over a mean follow-up of 21 ± 5 months, dronedarone consistently reduced risk of death or cardiovascular hospitalization (hazard ratio 0.76; 95% confidence interval 0.69-0.84) without heterogeneity based on HF status (p

conclusionsDronedarone is associated with reduced cardiovascular events in patients with paroxysmal or persistent AF/AFL and HF across the spectrum of LVEF, including among those with HFpEF and HFmrEF. These data support a rationale for a future dedicated and powered clinical trial to affirm the net clinical benefit of dronedarone in this population.

Indexed as

Atrial FibrillationAtrial FlutterHeart FailureVentricular Dysfunction, LeftAgedAged, 80 and overDronedaroneFemaleHumansMaleMiddle AgedPrognosisStroke VolumeVentricular Function, LeftDronedaroneAntiarrhythmic drugsAtrial fibrillationDronedaroneHeart failure with preserved ejection fraction

Identifiers

PMID35293087
PMCPMC9543163
OpenAlexW4220977210

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.