{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:03:08Z","timestamp":1784818988203,"version":"3.55.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021515","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This post-hoc analysis of the ATHENA trial assessed whether dronedarone (400\u2005mg twice daily) improved cardiovascular outcomes compared with placebo in patients with early atrial fibrillation\/atrial flutter (AF) and cardiovascular comorbidities, based on EAST-AFNET 4 inclusion criteria and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The co-primary outcomes were (i) a composite of cardiovascular death, stroke, or hospitalisation due to worsening of heart failure (HF) or acute coronary syndrome (ACS) and (ii) nights spent in hospital per year. Sinus rhythm (SR) at 12 months was a secondary outcome. The primary safety outcome was a composite of death, stroke, or pre-specified serious adverse events of special interest (AESIs) related to rhythm control therapy. 1810 patients with early AF were identified. Patients receiving dronedarone had fewer deaths from cardiovascular causes, strokes, or hospitalisations due to worsening of HF or ACS compared with patients receiving placebo [dronedarone (n = 924), 87 patients with \u22651 event; placebo (n = 886), 117 patients with \u22651 event; hazard ratio 0.71; 95% confidence interval 0.54\u20130.94; P = 0.014]. Number of nights spent in hospital did not differ between treatment groups. More patients receiving dronedarone (69.2%) were in SR at 12 months compared with placebo (60.8%). Primary safety events comprising death, stroke, or pre-specified serious AESIs related to rhythm control therapy were not different (dronedarone vs. placebo: 60 vs. 71 patients with \u22651 event).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These data support the use of dronedarone for early rhythm control therapy in selected patients with early AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>ATHENA: ClinicalTrials.gov identifier NCT00174785. EAST-AFNET 4: ClinicalTrials.gov identifier NCT01288352.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaf080","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T02:49:29Z","timestamp":1745894969000},"source":"Crossref","is-referenced-by-count":7,"title":["Dronedarone provides effective early rhythm control: post-hoc analysis of the ATHENA trial using EAST-AFNET 4 criteria"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0197","authenticated-orcid":false,"given":"Paulus","family":"Kirchhof","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg\u2013Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2536-2871","authenticated-orcid":false,"given":"A John","family":"Camm","sequence":"additional","affiliation":[{"name":"Institute of Molecular and Clinical Sciences, St. George\u2019s University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-5337","authenticated-orcid":false,"given":"Harry J G M","family":"Crijns","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre and Cardiovascular Research Institute , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":false,"given":"Jonathan P","family":"Piccini","sequence":"additional","affiliation":[{"name":"Duke University Medical Center and the Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"Department of Cardiology, Nordj\u00e6llands Hospital , Hiller\u00f8d ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4402-6814","authenticated-orcid":false,"given":"David S","family":"McKindley","sequence":"additional","affiliation":[{"name":"Sanofi , Bridgewater, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-6549","authenticated-orcid":false,"given":"Mattias","family":"Wieloch","sequence":"additional","affiliation":[{"name":"Sanofi , Paris ,","place":["France"]},{"name":"Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-3315","authenticated-orcid":false,"given":"Stefan H","family":"Hohnloser","sequence":"additional","affiliation":[{"name":"Department of Cardiology, J.W. Goethe University , Theodor-W.-Adorno-Platz 1, 60629 Frankfurt am Main ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"2025042822492169400_euaf080-B1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/clc.20989","article-title":"Can we predict outcomes in atrial fibrillation?","volume":"35","author":"Desai","year":"2012","journal-title":"Clin Cardiol"},{"key":"2025042822492169400_euaf080-B2","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1161\/CIRCULATIONAHA.112.000491","article-title":"Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study","volume":"128","author":"Marijon","year":"2013","journal-title":"Circulation"},{"key":"2025042822492169400_euaf080-B3","author":"National Institute for Health and Care 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