Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation　― A Meta-Analysis

Background:Atrial fibrillation (AF) recurrence remains a tricky problem in patients undergoing ablation. This meta-analysis aimed to summarize the current literature to clarify whether renin-angiotensin system inhibitors (RASIs) prevent AF recurrence after ablation.Methods and Results:Relevant studi...

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Bibliographic Details
Published in:Circulation Journal 2020/09/25, Vol.84(10), pp.1709-1717
Main Authors: Peng, Long, Li, Zexiong, Luo, Yanting, Tang, Xixiang, Shui, Xing, Xie, Xujing, Zheng, Zhenda, Dong, Ruimin, Liu, Jinlai, Zhu, Jieming, Li, Suhua
Format: Article
Language:English
Subjects:
Ablation
Angiotensin
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Atrial fibrillation
Atrial Fibrillation - prevention & control
Atrial Fibrillation - surgery
Catheter Ablation - methods
Female
Follow-Up Studies
Humans
Male
Meta-analysis
Middle Aged
Recurrence
Renin
Renin-Angiotensin System - drug effects
Risk Factors
Treatment Outcome
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Summary:Background:Atrial fibrillation (AF) recurrence remains a tricky problem in patients undergoing ablation. This meta-analysis aimed to summarize the current literature to clarify whether renin-angiotensin system inhibitors (RASIs) prevent AF recurrence after ablation.Methods and Results:Relevant studies were searched on Pubmed and EMBASE through December 2019. Pooled relative risk (RR) of AF recurrence was calculated. Subgroup analyses according to study design, race, and follow-up duration were further performed. A total of 15 studies examining 4,300 patients were included, with 3 randomized controlled trials and 12 cohort studies. Overall analysis showed that RASIs significantly reduced AF recurrence after ablation (RR=0.83; 95% confidence interval (CI) 0.70–0.98, P=0.028; I2=68.9%). Subgroup analysis further indicated that positive results were found in randomized controlled trials (RR=0.51, 95% CI 0.37–0.70, P
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-20-0402