Mengqi Gong1, Zhiwei Zhang1, Nikolaos Fragakis2, Panagiotis Korantzopoulos3, Konstantinos P Letsas4, Guangping Li1, Gan-Xin Yan5, Tong Liu6. 1. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China. 2. Third Cardiology Department, Hippokrateion Hospital, Aristotle University, Medical School, Thessaloniki, Greece. 3. First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece. 4. Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece. 5. Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, Pennsylvania,; Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: YanG@mlhs.org. 6. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China. Electronic address: liutongdoc@126.com.
Abstract
BACKGROUND: Randomized controlled trials (RCTs) on the use of ranolazine (RN) for prevention and cardioversion of atrial fibrillation (AF) have yielded conflicting results. OBJECTIVE: The purpose of this study was to conduct a meta-analysis of RCTs to examine the potential role of RN in the prevention and cardioversion of AF. METHODS: PubMed and EMBASE were searched until June 2016. Of 484 initially identified studies, 8 RCTs were finally analyzed. RESULTS: The analysis of RCTs showed that RN significantly reduced the incidence of AF compared to the control group in various clinical settings, such as after cardiac surgery, in acute coronary syndromes, and post-electrical cardioversion of AF (relative risk [RR] 0.67, 95% confidence interval [CI] 0.52-0.87, Z = 3.06, P = .002). Furthermore, a higher conversion rate of AF from the combined use of RN and amiodarone compared to amiodarone alone (RR 1.23, 95% CI 1.08-1.40, Z = 3.07, P = .002) was clear, with conversion time significantly shorter in RN plus amiodarone compared to the amiodarone group (weighted mean difference [WMD] = -10.38 hours, 95% CI -18.18 to -2.57, Z = 2.61, P = .009). CONCLUSION: Our meta-analysis suggests that RN may be effective in AF prevention, whereas it potentiates and accelerates the conversion effect of amiodarone of recent-onset AF. Larger RCTs with long-term follow-up in diverse clinical settings are needed to further clarify the impact of RN on AF therapy.
BACKGROUND: Randomized controlled trials (RCTs) on the use of ranolazine (RN) for prevention and cardioversion of atrial fibrillation (AF) have yielded conflicting results. OBJECTIVE: The purpose of this study was to conduct a meta-analysis of RCTs to examine the potential role of RN in the prevention and cardioversion of AF. METHODS: PubMed and EMBASE were searched until June 2016. Of 484 initially identified studies, 8 RCTs were finally analyzed. RESULTS: The analysis of RCTs showed that RN significantly reduced the incidence of AF compared to the control group in various clinical settings, such as after cardiac surgery, in acute coronary syndromes, and post-electrical cardioversion of AF (relative risk [RR] 0.67, 95% confidence interval [CI] 0.52-0.87, Z = 3.06, P = .002). Furthermore, a higher conversion rate of AF from the combined use of RN and amiodarone compared to amiodarone alone (RR 1.23, 95% CI 1.08-1.40, Z = 3.07, P = .002) was clear, with conversion time significantly shorter in RN plus amiodarone compared to the amiodarone group (weighted mean difference [WMD] = -10.38 hours, 95% CI -18.18 to -2.57, Z = 2.61, P = .009). CONCLUSION: Our meta-analysis suggests that RN may be effective in AF prevention, whereas it potentiates and accelerates the conversion effect of amiodarone of recent-onset AF. Larger RCTs with long-term follow-up in diverse clinical settings are needed to further clarify the impact of RN on AF therapy.
Authors: Irene Del-Canto; Lidia Gómez-Cid; Ismael Hernández-Romero; María S Guillem; María Eugenia Fernández-Santos; Felipe Atienza; Luis Such; Francisco Fernández-Avilés; Francisco J Chorro; Andreu M Climent Journal: Front Physiol Date: 2020-08-04 Impact factor: 4.566
Authors: Anh Tuan Ton; William Nguyen; Katrina Sweat; Yannick Miron; Eduardo Hernandez; Tiara Wong; Valentyna Geft; Andrew Macias; Ana Espinoza; Ky Truong; Lana Rasoul; Alexa Stafford; Tamara Cotta; Christina Mai; Tim Indersmitten; Guy Page; Paul E Miller; Andre Ghetti; Najah Abi-Gerges Journal: Sci Rep Date: 2021-06-08 Impact factor: 4.379