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Ci-dessous, les différences entre deux révisions de la page.

--- lbs.04 [2025/11/09 19:27] – clementbecle
+++ lbs.04 [2025/11/09 19:42] (Version actuelle) – clementbecle
@@ Ligne 1: / Ligne 1: @@
 ====== LBS.04 Late-Breaking Trials on Pharmacological and Dietary in AF ======
-- The DARE-AF Trial (Dapagliflozin/SGLT2i):
+===== The DARE-AF Trial (Dapagliflozin/SGLT2i) =====
-  - Objective: To test if dapagliflozin could reduce early AF recurrence after catheter ablation in persistent AF patients without standard indications for SGLT2 inhibitors (diabetes, heart failure, CKD).
+L'étude [[DARE-AF]] a montré que la dapagliflozine ne réduit pas la récidive précoce de la FA après ablation chez les patients sans indications SGLT2i standard, suggérant un effet indirect via les conditions cardiométaboliques.
-  - Design: 200 patients were randomized post-ablation to dapagliflozin 10 mg or control for three months.
-  - Results: There was no significant difference in AF burden at three months between the groups.
-  - Conclusion: The anti-arrhythmic effect of SGLT2 inhibitors likely stems from improving underlying cardiometabolic conditions rather than a direct effect. This reinforces the importance of proven lifestyle and risk factor modification.
+===== The META-AF Trial (Metformin) =====
-- The META-AF Trial (Metformin):
+L'étude [[META-AF]] suggère que la metformine réduit la récidive d'arythmie auriculaire post-ablation chez les patients en surpoids/obèses sans diabète, avec 78% de liberté contre 58% pour le groupe témoin.
-  - Objective: To test if metformin could reduce AF recurrence after catheter ablation in overweight or obese patients without diabetes.
-  - Design: Patients were randomized to metformin plus lifestyle counseling or lifestyle counseling alone.
+===== The DECAF Trial (Coffee) =====
-  - Results: The metformin arm had greater freedom from recurrent atrial arrhythmia (78%) compared to the control arm (58%). The effect was not explained by significant changes in weight or A1c.
+L'étude [[DECAF]] a montré que la consommation de café n'augmentait pas le risque de récidive de FA/flutter après cardioversion, défiant la sagesse conventionnelle et soutenant de nouvelles directives.
-  - Conclusion: Despite limitations (open-label, single-center, high intolerance rate), the provocative results suggest metformin may have an anti-arrhythmic benefit and warrant further investigation in a larger trial.
-- The DECAF Trial (Coffee):
-  - Objective: To test the effect of coffee consumption on AF recurrence after elective cardioversion.
-  - Design: Patients who regularly drank coffee were randomized to either continue drinking at least one cup per day or abstain from all caffeine for six months.
-  - Results: The coffee consumption group had a significantly lower risk of recurrent AF or flutter compared to the abstinence group (a 30% lower hazard).
-  - Conclusion: This supports the new guideline recommendation that caffeine cessation is given a Class 3 (no benefit) recommendation for preventing AF. Random allocation to coffee consumption resulted in less arrhythmia.