TABLE 2.
Baseline characteristics before overlap weighting.
| Non-frail (n = 14,429) | Moderately frail (n = 5,135) | Highly frail (n = 1,047) | |||||||
| Variables | Rhythm control (n = 6,520) | Rate control (n = 7,909) | ASD (%) | Rhythm control (n = 2,500) | Rate control (n = 2,635) | ASD (%) | Rhythm control (n = 514) | Rate control (n = 533) | ASD (%) |
| Age (years) | 72 (68–76) | 73 (69–78) | 23.9 | 74 (70–79) | 75 (71–80) | 18.6 | 76 (71–81) | 77 (72–83) | 18.8 |
| 65–74 | 4,349 (66.7) | 4,548 (57.5) | 19.0 | 1,314 (52.6) | 1,166 (44.3) | 16.7 | 215 (41.8) | 194 (36.4) | 11.1 |
| ≥75 | 2,171 (33.3) | 3,361 (42.5) | 19.0 | 1,186 (47.4) | 1,469 (55.7) | 16.7 | 299 (58.2) | 339 (63.6) | 11.1 |
| Male | 1,776 (49.5) | 1,827 (51.6) | 7.5 | 1,121 (44.8) | 1,247 (47.3) | 5.0 | 187 (36.4) | 234 (43.9) | 15.4 |
| AF duration (months) | 0.1 (0.0–1.2) | 0.0 (0.0–0.0) | 30.5 | 0.0 (0.0–1.2) | 0.0 (0.0–0.2) | 22.9 | 0.0 (0.0–1.3) | 0.0 (0.0–1.0) | 1.9 |
| Enrollment year: | |||||||||
| 2005 | 353 (5.4) | 1,078 (13.6) | 28.3 | 65 (2.6) | 146 (5.5) | 14.9 | 7 (1.4) | 18 (3.4) | 13.3 |
| 2006 | 374 (5.7) | 841 (10.6) | 17.9 | 83 (3.3) | 157 (6.0) | 12.6 | 8 (1.6) | 21 (3.9) | 14.6 |
| 2007 | 351 (5.4) | 632 (8.0) | 10.5 | 92 (3.7) | 146 (5.5) | 8.9 | 13 (2.5) | 16 (3.0) | 2.9 |
| 2008 | 339 (5.2) | 628 (7.9) | 11.1 | 106 (4.2) | 193 (7.3) | 13.2 | 13 (2.5) | 30 (5.6) | 15.7 |
| 2009 | 378 (5.8) | 555 (7.0) | 5.0 | 122 (4.9) | 133 (5.0) | 0.8 | 22 (4.3) | 29 (5.4) | 5.4 |
| 2010 | 454 (7.0) | 526 (6.7) | 1.2 | 166 (6.6) | 189 (7.2) | 2.1 | 29 (5.6) | 38 (7.1) | 6.1 |
| 2011 | 569 (8.7) | 539 (6.8) | 7.1 | 212 (8.5) | 230 (8.7) | 0.9 | 42 (8.2) | 39 (7.3) | 3.2 |
| 2012 | 655 (10.0) | 615 (7.8) | 8.0 | 242 (9.7) | 261 (9.9) | 0.8 | 55 (10.7) | 47 (8.8) | 6.3 |
| 2013 | 800 (12.3) | 739 (9.3) | 9.4 | 369 (14.8) | 320 (12.1) | 7.7 | 78 (15.2) | 79 (14.8) | 1.0 |
| 2014 | 937 (14.4) | 731 (9.2) | 15.9 | 426 (17.0) | 348 (13.2) | 10.7 | 112 (21.8) | 76 (14.3) | 19.7 |
| 2015 | 1,310 (20.1) | 1,025 (13.0) | 19.3 | 617 (24.7) | 512 (19.4) | 12.7 | 135 (26.3) | 140 (26.3) | <0.1 |
| High tertile of income | 3,419 (52.4) | 3,168 (40.1) | 25.0 | 1,219 (48.8) | 1,164 (44.2) | 9.2 | 256 (49.8) | 263 (49.3) | 0.9 |
| Number of OPD visits ≥12/year | 5,813 (89.2) | 6,313 (79.8) | 26.0 | 2,174 (87.0) | 1,964 (74.5) | 31.9 | 387 (75.3) | 346 (64.9) | 22.8 |
| Living in metropolitan areas | 3,230 (49.5) | 3,284 (41.5) | 16.2 | 1,097 (43.9) | 994 (37.7) | 12.6 | 203 (39.5) | 196 (36.8) | 5.6 |
| Level of care initiating treatment | |||||||||
| Tertiary | 4,019 (61.6) | 3,120 (39.4) | 45.5 | 1,348 (53.9) | 1,030 (39.1) | 30.1 | 257 (50.0) | 176 (33.0) | 35.0 |
| Secondary | 2,199 (33.7) | 3,899 (49.3) | 32.0 | 1,104 (44.2) | 1,489 (56.5) | 24.9 | 251 (48.8) | 338 (63.4) | 29.7 |
| Primary | 302 (4.6) | 890 (11.3) | 24.7 | 48 (1.9) | 116 (4.4) | 14.2 | 6 (1.2) | 19 (3.6) | 15.8 |
| CHA2DS2-VASc score | 4 (3–5) | 4 (3–5) | 15.2 | 5 (4–6) | 5 (4–6) | 20.7 | 6 (5–7) | 6 (5–7) | 33.3 |
| mHAS-BLED score* | 3 (2–3) | 2 (2–3) | 38.8 | 3 (3–4) | 3 (2–4) | 34.7 | 4 (3–4) | 3 (3–4) | 37.4 |
| Charlson comorbidity index | 3 (2–5) | 2 (1–4) | 53.4 | 5 (3–7) | 4 (2–6) | 49.1 | 7 (5–9) | 6 (4–8) | 44.9 |
| Hospital frailty risk score | 0.8 (0.0–2.5) | 0.0 (0.0–2.2) | 13.1 | 8.0 (6.2–10.3) | 8.0 (6.2–10.4) | 1.2 | 19.0 (16.8–23.2) | 19.0 (16.6–23.1) | 3.0 |
| Medical history | |||||||||
| Heart failure | 2,761 (42.3) | 4,049 (51.2) | 17.8 | 1,331 (53.2) | 1,276 (48.4) | 9.6 | 315 (61.3) | 256 (48.0) | 26.9 |
| Previous hospitalization for heart failure | 705 (10.8) | 1,288 (16.3) | 16.0 | 427 (17.1) | 397 (15.1) | 5.5 | 106 (20.6) | 65 (12.2) | 22.9 |
| Hypertension | 5,432 (83.3) | 4,945 (62.5) | 48.1 | 2,187 (87.5) | 1,821 (69.1) | 45.7 | 476 (92.6) | 410 (76.9) | 44.7 |
| Diabetes | 1,700 (26.1) | 1,553 (19.6) | 15.4 | 929 (37.2) | 744 (28.2) | 19.1 | 246 (47.9) | 199 (37.3) | 21.4 |
| Dyslipidaemia | 5,234 (80.3) | 4,493 (56.8) | 52.2 | 2,183 (87.3) | 1,945 (73.8) | 34.6 | 465 (90.5) | 449 (84.2) | 18.8 |
| Ischemic stroke | 1,456 (22.3) | 1,678 (21.2) | 2.7 | 1,279 (51.2) | 1,478 (56.1) | 9.9 | 385 (74.9) | 420 (78.8) | 9.2 |
| Transient ischemic attack | 577 (8.8) | 401 (5.1) | 14.9 | 410 (16.4) | 290 (11.0) | 15.7 | 126 (24.5) | 87 (16.3) | 20.4 |
| Intracranial bleeding | 50 (0.8) | 66 (0.8) | 0.8 | 94 (3.8) | 113 (4.3) | 2.7 | 56 (10.9) | 57 (10.7) | 0.6 |
| Myocardial infarction | 548 (8.4) | 442 (5.6) | 11.1 | 383 (15.3) | 256 (9.7) | 17.0 | 112 (21.8) | 82 (15.4) | 16.5 |
| Peripheral arterial disease | 962 (14.8) | 625 (7.9) | 21.7 | 485 (19.4) | 297 (11.3) | 22.7 | 130 (25.3) | 91 (17.1) | 20.2 |
| Valvular heart disease | 517 (7.9) | 876 (11.1) | 10.7 | 230 (9.2) | 167 (6.3) | 10.7 | 29 (5.6) | 21 (3.9) | 8.0 |
| Chronic kidney disease | 267 (4.1) | 202 (2.6) | 8.6 | 265 (10.6) | 128 (4.9) | 21.6 | 99 (19.3) | 49 (9.2) | 29.1 |
| Proteinuria | 366 (5.6) | 358 (4.5) | 5.0 | 171 (6.8) | 124 (4.7) | 9.2 | 33 (6.4) | 28 (5.3) | 5.0 |
| Hyperthyroidism | 756 (11.6) | 559 (7.1) | 15.6 | 379 (15.2) | 255 (9.7) | 16.7 | 96 (18.7) | 52 (9.8) | 25.8 |
| Hypothyroidism | 799 (12.3) | 533 (6.7) | 18.9 | 408 (16.3) | 246 (9.3) | 21.0 | 106 (20.6) | 68 (12.8) | 21.2 |
| Malignancy | 1,407 (21.6) | 1,243 (15.7) | 15.1 | 797 (31.9) | 659 (25.0) | 15.3 | 188 (36.6) | 168 (31.5) | 10.7 |
| COPD | 1,969 (30.2) | 2,165 (27.4) | 6.2 | 1,120 (44.8) | 952 (36.1) | 17.7 | 269 (52.3) | 251 (47.1) | 10.5 |
| Chronic liver disease | 2,498 (38.3) | 2,031 (25.7) | 27.3 | 1,165 (46.6) | 972 (36.9) | 19.8 | 255 (49.6) | 223 (41.8) | 15.6 |
| Hypertrophic cardiomyopathy | 165 (2.5) | 101 (1.3) | 9.2 | 71 (2.8) | 22 (0.8) | 15.0 | 16 (3.1) | 4 (0.8) | 17.2 |
| Osteoporosis | 2,331 (35.8) | 2,233 (28.2) | 16.2 | 1,320 (52.8) | 1,220 (46.3) | 13.0 | 361 (70.2) | 336 (63.0) | 15.3 |
| Sleep apnea | 25 (0.4) | 10 (0.1) | 5.1 | 7 (0.3) | 3 (0.1) | 3.7 | 0 (0.0) | 3 (0.6) | 10.6 |
| Concurrent drugs† | |||||||||
| Oral anticoagulant | 6,520 (100.0) | 7,909 (100.0) | <0.1 | 2,500 (100.0) | 2,635 (100.0) | <0.1 | 514 (100.0) | 533 (100.0) | <0.1 |
| Warfarin | 5,627 (86.3) | 7,320 (92.6) | 20.4 | 2,090 (83.6) | 2,334 (88.6) | 14.4 | 421 (81.9) | 443 (83.1) | 3.2 |
| NOAC | 1,142 (17.5) | 774 (9.8) | 22.7 | 540 (21.6) | 410 (15.6) | 15.6 | 118 (23.0) | 112 (21.0) | 4.7 |
| Beta blocker | 2,866 (44.0) | 4,965 (62.8) | 38.4 | 1,100 (44.0) | 1,639 (62.2) | 37.1 | 236 (45.9) | 318 (59.7) | 27.8 |
| Non-DHP CCB | 923 (14.2) | 1,386 (17.5) | 9.2 | 330 (13.2) | 457 (17.3) | 11.5 | 72 (14.0) | 103 (19.3) | 14.3 |
| Digoxin | 601 (9.2) | 3,692 (46.7) | 91.9 | 223 (8.9) | 990 (37.6) | 72.1 | 54 (10.5) | 180 (33.8) | 58.4 |
| Aspirin | 1,803 (27.7) | 2,002 (25.3) | 5.3 | 655 (26.2) | 557 (21.1) | 11.9 | 133 (25.9) | 97 (18.2) | 18.6 |
| P2Y12 inhibitor | 630 (9.7) | 565 (7.1) | 9.1 | 299 (12.0) | 285 (10.8) | 3.6 | 90 (17.5) | 68 (12.8) | 13.3 |
| Statin | 2,621 (40.2) | 2,468 (31.2) | 18.9 | 1,182 (47.3) | 1,128 (42.8) | 9.0 | 267 (51.9) | 249 (46.7) | 10.5 |
| DHP-CCB | 1,522 (23.3) | 962 (12.2) | 29.6 | 585 (23.4) | 400 (15.2) | 20.9 | 122 (23.7) | 93 (17.4) | 15.6 |
| ACEI/ARB | 3,720 (57.1) | 4,634 (58.6) | 3.1 | 1,341 (53.6) | 1,334 (50.6) | 6.0 | 272 (52.9) | 235 (44.1) | 17.7 |
| Loop/thiazide diuretics | 2,792 (42.8) | 4,932 (62.4) | 39.9 | 1,140 (45.6) | 1,336 (50.7) | 10.2 | 238 (46.3) | 214 (40.2) | 12.4 |
| K+ sparing diuretics | 884 (13.6) | 2,164 (27.4) | 34.7 | 382 (15.3) | 528 (20.0) | 12.5 | 81 (15.8) | 83 (15.6) | 0.5 |
| Alpha blocker | 194 (3.0) | 221 (2.8) | 1.1 | 70 (2.8) | 88 (3.3) | 3.1 | 13 (2.5) | 19 (3.6) | 6.0 |
Values are presented as median (interquartile range) or n (%).
*Modified HAS-BLED = hypertension, 1 point; >65 years old, 1 point; stroke history, 1 point; bleeding history or predisposition, 1 point; labile international normalized ratio, not assessed; ethanol or drug abuse, 1 point; drug predisposing to bleeding, 1 point.
†Defined as a prescription fill of >90 days within 180 days after the first prescription for rhythm- or rate-control drugs or the performance of an ablation procedure for AF.
AAD, antiarrhythmic drug; ACEI, angiotensin converting enzyme inhibitor; AF, atrial fibrillation; ARB, angiotensin II receptor blocker; ASD, absolute standardized difference; CCB, calcium channel blocker; COPD, chronic obstructive pulmonary disease; DHP, dihydropyridine; NOAC, non-vitamin K antagonist oral anticoagulant; OPD, outpatient department.