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The Impact of Suppressing the Renin‐Angiotensin System on Atrial Fibrillation
Author(s) -
Kalus James S.,
Coleman Craig I.,
White C. Michael
Publication year - 2006
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270005283284
Subject(s) - atrial fibrillation , medicine , cardiology , cardioversion , renin–angiotensin system , blood pressure
Atrial fibrillation is very common in the United States. After a search of Medline, EMBASE, and CINAHL, 4 trials evaluating inhibitors of the renin‐angiotensin system were identified for prevention of new‐onset atrial fibrillation, facilitation of electrical cardioversion of atrial fibrillation, and prevention of atrial fibrillation recurrence after electrical cardioversion. A meta‐analysis was performed using a random‐effects model. Use of an angiotensin‐converting enzyme (ACE) inhibitor or angiotensin‐receptor blocker (ARB) was associated with a reduction in new‐onset atrial fibrillation (OR [95% CI] = 0.51 [0.36–0.72]), a lower failure rate of electrical cardioversion of atrial fibrillation (0.47 [0.24–0.92]), and a lower rate of recurrence of atrial fibrillation after electrical cardioversion (0.39 [0.20–0.75]). With the exception of the new‐onset atrial fibrillation analysis, these findings were not associated with statistical heterogeneity. These hypothesis‐generating data suggest that inhibitors of the renin‐angiotensin system may provide benefit across the spectrum of atrial fibrillation.