Min Han1, Yong Zhang, Shujuan Sun, Zhongsu Wang, Jiangrong Wang, Xinxing Xie, Mei Gao, Xiangcui Yin, Yinglong Hou. 1. *Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan City, China; †Department of Clinical Pharmacy (Seven-Year), School of Pharmaceutical Sciences, Shandong University, Jinan City, China; and Departments of ‡Pharmacy; and §Science and Education, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan City, China.
Abstract
OBJECTIVE: This study was designed to assess whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could prevent the recurrence of atrial fibrillation (AF). METHODS: A systemic literature search of PubMed, EMBASE, and Cochrane Controlled Trials Register till 2012 was performed to identify randomized controlled trials involving the prevention of recurrence of AF with renin-angiotensin system blockade therapy. Subgroup analysis and meta-regression were performed. Publication bias was checked through funnel plot and Egger's test. RESULTS: Twenty-one randomized controlled trials including 13,184 patients with AF were identified. Overall, the recurrence of AF was significantly reduced in patients using ACEI/ARBs [odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32-0.56; P < 0.00001], especially both in irbesartan subgroup (OR, 0.38; 95% CI, 0.21-0.68; P = 0.001) and in patients receiving antiarrhythmic drug (AAD) (OR, 0.37; 95% CI, 0.29-0.48; P < 0.00001), and there was no significant difference between ACEIs and ARBs (ACEIs: OR, 0.42; 95% CI, 0.31-0.57 and ARBs: OR, 0.42; 95% CI, 0.31-0.57). Moreover, it was found that the benefits of ACEI/ARBs revealed positive correlation to systolic blood pressure (regression coefficient: -0.0700257, P = 0.000) in no-AAD users. CONCLUSIONS: ACEI/ARBs are effective on the secondary prevention of AF, especially in patients receiving AAD and suffering from hypertension.
OBJECTIVE: This study was designed to assess whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could prevent the recurrence of atrial fibrillation (AF). METHODS: A systemic literature search of PubMed, EMBASE, and Cochrane Controlled Trials Register till 2012 was performed to identify randomized controlled trials involving the prevention of recurrence of AF with renin-angiotensin system blockade therapy. Subgroup analysis and meta-regression were performed. Publication bias was checked through funnel plot and Egger's test. RESULTS: Twenty-one randomized controlled trials including 13,184 patients with AF were identified. Overall, the recurrence of AF was significantly reduced in patients using ACEI/ARBs [odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32-0.56; P < 0.00001], especially both in irbesartan subgroup (OR, 0.38; 95% CI, 0.21-0.68; P = 0.001) and in patients receiving antiarrhythmic drug (AAD) (OR, 0.37; 95% CI, 0.29-0.48; P < 0.00001), and there was no significant difference between ACEIs and ARBs (ACEIs: OR, 0.42; 95% CI, 0.31-0.57 and ARBs: OR, 0.42; 95% CI, 0.31-0.57). Moreover, it was found that the benefits of ACEI/ARBs revealed positive correlation to systolic blood pressure (regression coefficient: -0.0700257, P = 0.000) in no-AAD users. CONCLUSIONS:ACEI/ARBs are effective on the secondary prevention of AF, especially in patients receiving AAD and suffering from hypertension.
Authors: Evan L Thacker; Paul N Jensen; Bruce M Psaty; Barbara McKnight; W T Longstreth; Sascha Dublin; Katherine M Newton; Nicholas L Smith; David S Siscovick; Susan R Heckbert Journal: Ann Pharmacother Date: 2015-01-27 Impact factor: 3.154
Authors: Marat Fudim; Peter R Liu; Peter Shrader; Rosalia G Blanco; Larry A Allen; Gregg C Fonarow; Bernard J Gersh; Peter R Kowey; Kenneth W Mahaffey; Elaine Hylek; Alan S Go; Laine Thomas; Eric D Peterson; Jonathan P Piccini Journal: J Am Heart Assoc Date: 2018-04-13 Impact factor: 5.501