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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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| Published in: | Circulation Journal 2020/09/25, Vol.84(10), pp.1709-1717 |
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| container_end_page | 1717 |
| container_issue | 10 |
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| container_title | Circulation Journal |
| container_volume | 84 |
| creator | Peng, Long Li, Zexiong Luo, Yanting Tang, Xixiang Shui, Xing Xie, Xujing Zheng, Zhenda Dong, Ruimin Liu, Jinlai Zhu, Jieming Li, Suhua |
| description | 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 |
| doi_str_mv | 10.1253/circj.CJ-20-0402 |
| format | article |
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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<0.001; I2=4%), studies conducted in Asia (RR=0.59, 95% CI 0.46–0.76, P<0.001; I2=30.7%), and studies with follow-up duration ≥1 year (RR=0.82, 95% CI 0.70–0.95, P=0.01; I2=59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year.Conclusions:RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-20-0402</identifier><identifier>PMID: 32879151</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>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</subject><ispartof>Circulation Journal, 2020/09/25, Vol.84(10), pp.1709-1717</ispartof><rights>2020 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552t-830cbfc4dbeed2e2e282ca6e95a3f3d2148c72b0f9ac3854cf0dcdeccb570b943</citedby><cites>FETCH-LOGICAL-c552t-830cbfc4dbeed2e2e282ca6e95a3f3d2148c72b0f9ac3854cf0dcdeccb570b943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32879151$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peng, Long</creatorcontrib><creatorcontrib>Li, Zexiong</creatorcontrib><creatorcontrib>Luo, Yanting</creatorcontrib><creatorcontrib>Tang, Xixiang</creatorcontrib><creatorcontrib>Shui, Xing</creatorcontrib><creatorcontrib>Xie, Xujing</creatorcontrib><creatorcontrib>Zheng, Zhenda</creatorcontrib><creatorcontrib>Dong, Ruimin</creatorcontrib><creatorcontrib>Liu, Jinlai</creatorcontrib><creatorcontrib>Zhu, Jieming</creatorcontrib><creatorcontrib>Li, Suhua</creatorcontrib><title>Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation ― A Meta-Analysis</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>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<0.001; I2=4%), studies conducted in Asia (RR=0.59, 95% CI 0.46–0.76, P<0.001; I2=30.7%), and studies with follow-up duration ≥1 year (RR=0.82, 95% CI 0.70–0.95, P=0.01; I2=59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year.Conclusions:RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.</description><subject>Ablation</subject><subject>Angiotensin</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - prevention & control</subject><subject>Atrial Fibrillation - surgery</subject><subject>Catheter Ablation - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Recurrence</subject><subject>Renin</subject><subject>Renin-Angiotensin System - drug effects</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpFkMtuHCEQRVGUKH7E-6wiltm0QwPtgWVrFDu2bCVy4jWC6sLDqId2gLE0i0jzE_nB-EfS87CtkqgSnHsLXUI-1uy05o34AiHB_HR6VXFWMcn4G3JYCzmppOLs7XY-q7SS4oAc5TxnjGvW6PfkQHA10XVTH5I_txhDrNp4H4aCMYdIf65ywQW9jLPgQhlSpn5ItMyQ_kj4iLGEIdLB07akYHt6HlwKfW-317cIy5QwAtLWF0y0dbuXp_X63_ovbekNFjuus_0qh_yBvPO2z3iy78fk7vzrr-m36vr7xeW0va6gaXiplGDgPMjOIXYcx1Ic7BnqxgovOl5LBRPumNcWhGokeNZBhwCumTCnpTgmn3e-D2n4vcRczCJkwPHXEYdlNlwKrRVTSowo26GQhpwTevOQwsKmlamZ2YRutqGb6ZXhzGxCHyWf9u5Lt8DuRfCc8ghc7IB5LvYeXwCbSoAe945KblaM56v1KzGzyWAU_wFwAJyG</recordid><startdate>20200925</startdate><enddate>20200925</enddate><creator>Peng, Long</creator><creator>Li, Zexiong</creator><creator>Luo, Yanting</creator><creator>Tang, Xixiang</creator><creator>Shui, Xing</creator><creator>Xie, Xujing</creator><creator>Zheng, Zhenda</creator><creator>Dong, Ruimin</creator><creator>Liu, Jinlai</creator><creator>Zhu, Jieming</creator><creator>Li, Suhua</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200925</creationdate><title>Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation ― A Meta-Analysis</title><author>Peng, Long ; Li, Zexiong ; Luo, Yanting ; Tang, Xixiang ; Shui, Xing ; Xie, Xujing ; Zheng, Zhenda ; Dong, Ruimin ; Liu, Jinlai ; Zhu, Jieming ; Li, Suhua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c552t-830cbfc4dbeed2e2e282ca6e95a3f3d2148c72b0f9ac3854cf0dcdeccb570b943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>Angiotensin</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - prevention & control</topic><topic>Atrial Fibrillation - surgery</topic><topic>Catheter Ablation - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Recurrence</topic><topic>Renin</topic><topic>Renin-Angiotensin System - drug effects</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peng, Long</creatorcontrib><creatorcontrib>Li, Zexiong</creatorcontrib><creatorcontrib>Luo, Yanting</creatorcontrib><creatorcontrib>Tang, Xixiang</creatorcontrib><creatorcontrib>Shui, Xing</creatorcontrib><creatorcontrib>Xie, Xujing</creatorcontrib><creatorcontrib>Zheng, Zhenda</creatorcontrib><creatorcontrib>Dong, Ruimin</creatorcontrib><creatorcontrib>Liu, Jinlai</creatorcontrib><creatorcontrib>Zhu, Jieming</creatorcontrib><creatorcontrib>Li, Suhua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peng, Long</au><au>Li, Zexiong</au><au>Luo, Yanting</au><au>Tang, Xixiang</au><au>Shui, Xing</au><au>Xie, Xujing</au><au>Zheng, Zhenda</au><au>Dong, Ruimin</au><au>Liu, Jinlai</au><au>Zhu, Jieming</au><au>Li, Suhua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation ― A Meta-Analysis</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2020-09-25</date><risdate>2020</risdate><volume>84</volume><issue>10</issue><spage>1709</spage><epage>1717</epage><pages>1709-1717</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>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<0.001; I2=4%), studies conducted in Asia (RR=0.59, 95% CI 0.46–0.76, P<0.001; I2=30.7%), and studies with follow-up duration ≥1 year (RR=0.82, 95% CI 0.70–0.95, P=0.01; I2=59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year.Conclusions:RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>32879151</pmid><doi>10.1253/circj.CJ-20-0402</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Freely Accessible Journals |
| 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 |
| title | Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation ― A Meta-Analysis |
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