Key result
ARNI linked to ~61% lower AF recurrence risk vs ACEI after first-time catheter ablation.
Why the study?
The relationship between ARNI therapy and the recurrence of AF after radiofrequency catheter ablation was unknown.
Does angiotensin receptor-neprilysin inhibitor (ARNI) therapy reduce the recurrence of atrial fibrillation in patients undergoing first-time radiofrequency catheter ablation compared to ACEI?
Cohort (n=679)
Does angiotensin receptor-neprilysin inhibitor (ARNI) therapy reduce the recurrence of atrial fibrillation in patients undergoing first-time radiofrequency catheter ablation compared to ACEI?
In patients undergoing first-time radiofrequency catheter ablation for atrial fibrillation, ARNI therapy significantly reduced the risk of AF recurrence compared to ACEI therapy.
Answers are grounded in this paper and cite their sources.
May support ARNI over ACEI post-ablation; hypothesis-generating and requires RCT confirmation before practice change.
Background Compared with conventional medicines, angiotensin receptor-neprilysin inhibitor (ARNI) could further improve the prognosis for multiple cardiovascular diseases, such as heart failure, hypertension, and myocardial infarction. However, the relationship between ARNI therapy and the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation is currently unknown. Methods This study is a retrospective cohort study. Patients with consecutive persistent or paroxysmal AF undergoing first-time radiofrequency ablation were enrolled from February 2018 to October 2021. We compared the risk of AF recurrence in patients with catheter ablation who received ARNI with the risk of AF recurrence in those who received the angiotensin-converting enzyme inhibitor (ACEI). The propensity-score matched analysis was conducted to examine the effectiveness of ARNI. We used a Cox regression model to evaluate AF recurrence events. Results Among 679 eligible patients, 155 patients with ARNI treatment and 155 patients with ACEI treatment were included in the analyses. At a median follow-up of 228 (196–322) days, ARNI as compared with ACEI was associated with a lower risk of AF recurrence [adjusted hazard ratio (HR), 0.39; 95% confidence interval (CI), 0.24–0.63; p < 0.001]. In addition, no interaction was found in the subgroup analysis. Conclusion Angiotensin receptor-neprilysin inhibitor treatment was associated with a decreased risk of AF recurrence after first-time radiofrequency catheter ablation.
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Dong et al. (2022) conducted a cohort in Atrial fibrillation (n=679). Angiotensin receptor-neprilysin inhibitor (ARNI) vs. Angiotensin-converting enzyme inhibitor (ACEI) was evaluated on AF recurrence (HR 0.39, 95% CI 0.24-0.63, p=<0.001). ARNI therapy was associated with a lower risk of AF recurrence compared with ACEI after first-time radiofrequency catheter ablation.
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