The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females

• Published in: Europace (London, England) England), 2010-03, Vol.12 (3), p.322-330
• Main Authors: Patel, Dimpi, Mohanty, Prasant, Di Biase, Luigi, Wang, Yan, Shaheen, Mazen H., Sanchez, Javier E., Horton, Rodney P., Gallinghouse, G. Joseph, Zagrodzky, Jason D., Bailey, Shane M., Burkhardt, J. David, Lewis, William R., Diaz, Alberto, Beheiry, Salwa, Hongo, Richard, Al-Ahmad, Amin, Wang, Paul, Schweikert, Robert, Natale, Andrea
• Format: Article
• Language: English
• Subjects: Aged; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Atrial Fibrillation - drug therapy; Atrial Fibrillation - epidemiology; Atrial Fibrillation - surgery; C-Reactive Protein - metabolism; Catheter Ablation - methods; Catheter Ablation - statistics & numerical data; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Kaplan-Meier Estimate; Middle Aged; Postmenopause; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Predictive Value of Tests; Proportional Hazards Models; Renin-Angiotensin System - drug effects; Risk Factors; Secondary Prevention; Treatment Outcome
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/eup387

Aims To assess whether treatment with statins or renin-angiotensin-aldosterone system (RAAS) inhibitors as potential procedural 'augmenting agents' improved atrial fibrillation (AF) catheter ablation recurrence rates in post-menopausal females (PMFS). Methods and results Five hundred and eighteen consecutive female patients had undergone AF catheter ablation from January 2005 to May 2008. Post-menopausal females were selected and procedure outcomes were compared between cohorts of PMFS treated with statins or RAAS inhibitors to untreated PMFS. Out of 408 PMFS, 36 (8.8%) were treated with a combination of RAAS inhibitors and statins, thus were excluded leaving a total of 372 (91.2%) patients in the study. Out of 372 patients, 111 (29.8%) were on statins (Group 1), 59 (15.9%) on RAAS inhibitors (Group 2), and 202 (54.3%) without RAAS inhibitors or statins [(Group 3) control population]. Over a mean follow-up time of 24 ± 8.3 (median 25) months, 78 (70.6%) in Group 1, 38 (65.4%) in Group 2, and 139 (68.8%) in Group 3 had procedural success. Statin or RAAS inhibitor use did not predict lower recurrence rates [hazard ratio (HR): 1.26, P = 0.282 and HR: 1.14, P = 0.728, respectively]. When compared with controls, no difference in the cumulative incidence of recurrence was found with statin or RAAS inhibitors use (P = 0.385 and P = 0.761, respectively). Conclusion Treatment with statins or RAAS inhibitors did not improve catheter ablation success rates among PMFS. Thereby, from a clinical standpoint, PMFS should not be started on these treatments as a procedural 'augmenting agent' at this time.