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Published on: February 26, 2013

Renin-angiotensin system inhibitors for prevention of recurrent atrial fibrillation: a meta-analysis

T-J Li1, W-D Zang, Y-L Chen

  • 1Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China. litiejun@medmail.com.cn

International Journal of Clinical Practice
|April 6, 2013
PubMed
Abstract

Insights

Renin-angiotensin system (RAS) inhibitors effectively prevent atrial fibrillation (AF) recurrence in patients. This meta-analysis confirms their safety and tolerability, offering a valuable therapeutic option for managing AF relapse.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Conflicting clinical utility data exists for renin-angiotensin system (RAS) inhibitors in atrial fibrillation (AF) patients.
  • Randomized controlled trials (RCTs) provide a basis for evaluating RAS blockade's efficacy in preventing AF relapse.

Purpose of the Study:

  • To conduct a meta-analysis of RCTs to determine the efficacy and safety of RAS inhibitors in preventing AF recurrence.
  • To assess the impact of RAS blockade on AF relapse in both paroxysmal and persistent AF populations.

Main Methods:

  • Searched Medline, ISI Web of Science, and Cochrane databases up to January 2012.
  • Included RCTs comparing RAS inhibition with placebo or alternative therapies for AF management.
  • Calculated pooled odds ratios (OR) using a random effects model to assess outcomes.

Main Results:

  • Fifteen trials with 3972 patients were analyzed.
  • RAS inhibitors significantly reduced AF recurrence compared to non-RAS inhibitors (OR=0.50).
  • No significant difference in survival advantage or adverse event incidence was observed between RAS inhibitors and control groups.

Conclusions:

  • RAS inhibition is an effective, safe, and well-tolerated strategy for preventing AF recurrence.
  • The findings support the use of RAS inhibitors in managing patients prone to AF relapse.

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