Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial.

Importance: Data from randomized clinical trials on a long-term anticoagulation strategy for patients after catheter-based ablation for atrial fibrillation (AF) are lacking.

Objective: To evaluate whether discontinuing oral anticoagulant therapy provides superior clinical outcomes compared with continuing oral anticoagulant therapy in patients without documented atrial arrhythmia recurrence after catheter ablation for AF.

Design, Setting, And Participants: A randomized clinical trial including 840 adult patients (aged 19-80 years) who were enrolled and randomized from July 28, 2020, to March 9, 2023, at 18 hospitals in South Korea.

The optimal lookback period for estimating incidence and temporal trends in atrial fibrillation.

Background: Accurate measurement of atrial fibrillation (AF) incidence using secondary data is challenging due to variation in lookback period definitions used to distinguish incident from prevalent cases. As the choice of lookback period critically influences incidence estimates, establishing an appropriate duration is essential for sustained surveillance of AF trends.

Objectives: This study aimed to identify a reproducible definition of the lookback period and analyze trends in the incidence rate and prevalence of AF in Korea.

Racial differences in bleeding risks among patients with atrial fibrillation: An ecological epidemiological study comparing Korea and UK population.

Background: Racial differences in the propensity to bleeding may be evident, with a higher risk of bleeding in Asian populations. This study aimed to assess racial differences in bleeding risk among patients with atrial fibrillation (AF) using an ecological epidemiological approach.

Methods: We included patients with AF from the Korean National Health Insurance Service-Health Screening and UK Biobank who underwent health check-ups between 2006 and 2010.

Temporal trends in ischemic stroke and female sex as a risk modifier in atrial fibrillation: insights from non-anticoagulated Asian patients in a nationwide cohort study.

Background: Previous studies from Western populations have reported changing temporal trends in ischemic stroke (IS) incidence in females with atrial fibrillation (AF) when compared with males. Nationwide data on such temporal trends in AF-related IS incidence by sex are limited in Asian populations.

Methods: This population-based retrospective cohort study included patients with incident AF diagnosed between 2005 and 2016 from the Korean National Health Insurance Service.

Metabolic Status and Atrioventricular Block Risk: The Role of Physical Activity.

Background: The relationship between metabolic status as a possible risk factor and predictor of response to moderate-to-vigorous physical activity (MVPA) in atrioventricular block (AVB) remains unclear.

Methods: A total of 82,365 UK Biobank participants without a history of AVB or pacemaker implantation, and who were involved in accelerometer work-up, were chosen for the study population. Metabolic status was classified into two categories, healthy and unhealthy, using modified criteria for metabolic syndrome from the International Diabetes Federation.

Proteomic Signatures for Risk Prediction of Atrial Fibrillation.

Background: Proteomic signatures might improve disease prediction and enable targeted disease prevention and management. We explored whether a protein risk score derived from large-scale proteomics data improves risk prediction of atrial fibrillation (AF).

Methods: A total of 51 680 individuals with 1459 unique plasma protein measurements and without a history of AF were included from the UKB-PPP (UK Biobank Pharma Proteomics Project).

Integration of Left Atrial Function Assessment, Genetic Risk, and Clinical Risk Factors Improves Prediction of Incident Atrial Fibrillation.

Background: Integration of imaging, genetic, and clinical markers might improve risk assessment of atrial fibrillation (AF). We explored whether the addition of left atrial (LA) function and polygenic risk score (PRS) to a clinical risk score improves risk prediction of AF.

Methods: A total of 36 919 individuals without AF who were assessed for LA emptying fraction (evaluated by cardiac magnetic resonance imaging) and PRS were analyzed from the UK Biobank imaging enhancement.

Sex differences in the impact of marital status on coronary artery disease outcomes in Korea.

Background: Coronary artery disease (CAD) outcomes are influenced by social determinants, including marital status. However, research on the sex-specific effects of marital status on CAD outcomes is limited. This study aimed to evaluate the relationship between marital status and clinical outcomes of patients with CAD stratified according to sex in Korea.

Efficacy and safety of low-dose atorvastatin plus ezetimibe for primary hypercholesterolemia: A randomized, double-blind, multicenter phase 3 trial.

Studies have suggested that low-dose statin monotherapy may be insufficient for target LDL-C levels. In this randomized, double-blind, multicenter phase 3 trial, we evaluated the efficacy of combined ezetimibe and low-dose atorvastatin in 222 Korean patients with primary hypercholesterolemia. Participants received either 10-mg ezetimibe/5-mg atorvastatin (EZE10/ATV5), 10-mg ezetimibe (EZE10), 5-mg atorvastatin (ATV5), or 10-mg atorvastatin (ATV10).

A Phase III Randomized, Double-Blind, Active-Controlled, Multicenter Study on the Efficacy and Safety of Ezetimibe/Atorvastatin/Amlodipine Combination in Patients With Comorbid Primary Hypercholesterolemia and Essential Hypertension.

Purpose: This study aimed to evaluate the efficacy and safety of triple combination of ezetimibe (Eze)/atorvastatin (Ato) 10/40 mg + amlodipine (Aml) 10 mg therapy for lowering the low-density lipoprotein cholesterol (LDL-C) and blood pressure compared with either Eze/Ato 10/40 mg or Aml 10 mg therapies in patients with comorbid primary hypercholesterolemia and essential hypertension.

Methods: This was a randomized, multicenter, double-blind, active-controlled, Phase III clinical trial. Participants underwent a wash-out period (2 weeks for nonfibrate medications, 6 weeks for fibrates) followed by 4 weeks of therapeutic lifestyle changes.

Clinical and Genetic Risk Factors Predict Atrial Fibrillation on the Basis of Hypertrophic Cardiomyopathy.

Background: Clinical and genetic predispositions are significant in predicting atrial fibrillation (AF); however, their role in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aims to elucidate the impact of clinical and genetic risk factors on the development of AF in patients with and without HCM.

Methods And Results: This retrospective analysis involved data from the UK Biobank cohort.

Early Rhythm Control for Atrial Fibrillation in Patients With End-Stage or Chronic Kidney Disease.

Objective: To investigate the benefits and risks of early rhythm control (ERC) in patients with atrial fibrillation (AF) and chronic kidney disease (CKD).

Patients And Methods: This population-based cohort study included 5224 patients with AF (58.2% male, median age 70 years) with end-stage kidney disease (ESKD; n=1660) and CKD stage 3 to 4 (n=3564), who underwent ERC or rate control between January 1, 2005, and December 31, 2015.

Racial differences and similarities in atrial fibrillation epidemiology and risk factors in UK Biobank and Korean NHIS-HEALS cohort studies.

Background: The increasing prevalence of atrial fibrillation (AF) requires efforts to understand racial differences in disease distribution and risk factors.

Objective: We aimed to compare associations between risk factors and AF in White Europeans from the UK Biobank and Asians from the Korean National Health Insurance Service-Health Screening (NHIS-HEALS) study.

Methods: This study included participants from the Korean NHIS-HEALS and UK Biobank.

Associations of accelerometer-derived moderate-to-vigorous physical activity and atrioventricular block in a healthy elderly population.

Background: There is limited information on protective factors related to atrioventricular (AV) block.

Objective: This study examines the association between accelerometer-derived moderate-to-vigorous physical activity (MVPA) and AV block in healthy elderly individuals.

Methods: A total of 23,590 UK Biobank participants ≥60 years of age involved in a wrist-worn accelerometer study with no history of hypertension, diabetes mellitus, dyslipidemia, and coronary heart disease were analyzed.

Association of Adding Salt to Foods and Potassium Intake with Incident Atrial Fibrillation in the UK Biobank Study.

Background: High sodium and low potassium consumption are related to hypertension and cardiovascular disease. We aimed to determine the relationship between the frequency of salt addition and potassium consumption with the risk of new-onset atrial fibrillation (AF).

Methods: Our study used the UK Biobank cohort, which included over 500,000 individuals enrolled from the United Kingdom between 2006 and 2010.

The anticoagulation one year after ablation of atrial fibrillation in patients with atrial fibrillation (ALONE-AF) trial: Study protocol.

Background: The ideal long-term antithrombotic strategy for patients after successful catheter-based atrial fibrillation (AF) ablation is still uncertain. Presently, practices vary, and the advantages of oral anticoagulation (OAC) for the post-ablation population are not clearly established. To date, no randomized trials have addressed this therapeutic question.

All-Cause Death and Major Adverse Events in Atrial Fibrillation with Frailty: Observations from the Korea National Health Insurance Service Data.

Background: Atrial fibrillation (AF) is an indicator of frailty in old patients. This study aimed to investigate the effect of frailty on the use of oral anticoagulants (OAC) and clinical outcomes in a nationwide cohort of patients with new-onset AF.

Methods: This study included 451,368 participants without AF from the Korea National Health Insurance Service-Health Screening cohort between 2002 and 2009.

Clinical Implications of Polypharmacy for Patients with New-Onset Atrial Fibrillation Based on Real-World Data: Observations from the Korea National Health Insurance Service Data.

Background: Polypharmacy is commonly observed in atrial fibrillation (AF) and is associated with poorer clinical outcomes. Our study aimed to elucidate the polypharmacy prevalence, its associated risk factors, and its relationship with adverse clinical outcomes using a 'real-world' database.

Methods: This study included 451,368 subjects without prior history of AF (median age, 54 [interquartile range, 48.

The associations of leukocyte telomere length and intermediary cardiovascular phenotype with adverse cardiovascular outcomes in the white population.

The evidence about the associations of leukocyte telomere length (LTL) and intermediary cardiovascular phenotypes with adverse cardiovascular outcomes is inconclusive. This study assessed these relationships with cardiovascular imaging, electrocardiography, and the risks of sudden cardiac death (SCD), coronary events, and heart failure (HF) admission. We conducted a cross-sectional analysis of UK Biobank participants enrolled between 2006 and 2010.

Modifiable lifestyle factors and lifetime risk of atrial fibrillation: longitudinal data from the Korea NHIS-HealS and UK Biobank cohorts.

Background: The reason for higher incidence of atrial fibrillation (AF) in Europe compared with East Asia is unclear. We aimed to investigate the association between modifiable lifestyle factors and lifetime risk of AF in Europe and East Asia, along with race/ethnic similarities and disparities.

Methods: 1:1 propensity score matched pairs of 242,763 East Asians and 242,763 White Europeans without AF were analyzed.

Transient pacing in pigs with complete heart block via myocardial injection of mRNA coding for the T-box transcription factor 18.

The adenovirus-mediated somatic transfer of the embryonic T-box transcription factor 18 (TBX18) gene can convert chamber cardiomyocytes into induced pacemaker cells. However, the translation of therapeutic TBX18-induced cardiac pacing faces safety challenges. Here we show that the myocardial expression of synthetic TBX18 mRNA in animals generates de novo pacing and limits innate and inflammatory immune responses.

European and US Guideline-Based Statin Eligibility, Genetically Predicted Coronary Artery Disease, and the Risk of Major Coronary Events.

Background: A study was designed to investigate whether the coronary artery disease polygenic risk score (CAD-PRS) may guide lipid-lowering treatment initiation as well as deferral in primary prevention beyond established clinical risk scores.

Methods And Results: Participants were 311 799 individuals from the UK Biobank free of atherosclerotic cardiovascular disease, diabetes, chronic kidney disease, and lipid-lowering treatment at baseline. Participants were categorized as statin indicated, statin indication unclear, or statin not indicated as defined by the European and US guidelines on statin use.

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study.

Background:  This study aimed to evaluate racial differences in the incidence of stroke by conducting an ecological epidemiological study using UK Biobank and Korean nationwide data.

Methods:  This study used individual data from the Korean National Health Insurance Service-Health Screening and UK Biobank, which included participants who underwent health examinations between 2006 and 2010. We included 112,750 East Asians (50.