ArticleInternational journal of cardiology. Heart & vasculature2026
Phenotype-stratified treatment response in obese atrial fibrillation: Post-hoc cluster analysis of the PRAGUE-25 randomized trial.
Article in International journal of cardiology. Heart & vasculature, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Recent highlights from theInternational journal of cardiology. Heart & vasculature · 2026Article
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22 authors.
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Abstract
Background: The PRAGUE-25 trial demonstrated catheter ablation (CA) superiority over lifestyle modification plus antiarrhythmic drugs (LFM + AAD) in obese patients with atrial fibrillation (AF). However, obese AF patients represent a heterogeneous population with varying pathophysiological substrates. We hypothesized that distinct patient phenotypes may exhibit differential treatment responses. Methods: This post-hoc analysis applied hierarchical cluster analysis (Ward's D2 method, Euclidean distance) to 122 PRAGUE-25 patients with complete data using six delta (12-month minus baseline) echocardiographic and metabolic variables (Δ-LAVI, Δ-LVEDD, Δ-NT-proBNP, Δ-triglycerides, Δ-leukocytes, Δ-platelets). Treatment effects within each phenotype were compared using Fisher's exact test and odds ratios with 95% confidence intervals. Results: Three distinct phenotypes were identified: Metabolic (n = 20, 16%), characterized by highest triglycerides with minimal structural remodeling; Intermediate Remodeling (n = 67, 55%), distinguished by largest LV chamber with lowest inflammatory burden; and Advanced Neurohormonal/Inflammatory (n = 35, 29%), exhibiting highest NT-proBNP with elevated inflammatory markers. While cluster membership did not predict overall AF freedom (χ Conclusions: These hypothesis-generating findings suggest phenotype-dependent treatment response heterogeneity in obese atrial fibrillation. As cluster membership can only be determined retrospectively, prospective validation using baseline predictor models is required before clinical application.
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