January 10, 2010EP Europace46 citationsOpen Access
The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females
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Key Result
Treatment with statins or RAAS inhibitors did not improve catheter ablation success rates compared to controls (70.6% statins, 65.4% RAAS vs 68.8% control; statin HR 1.26, P=0.282).
Study Design
Type
Cohort (n=372)
Structured PICO
Does treatment with statins or RAAS inhibitors reduce atrial fibrillation recurrence in post-menopausal females undergoing catheter ablation?
P
Population
372 post-menopausal females who underwent atrial fibrillation catheter ablation
I
Intervention
Statins or renin-angiotensin-aldosterone system (RAAS) inhibitors
C
Comparator
No statins or RAAS inhibitors (control population)
O
Outcome
Atrial fibrillation catheter ablation recurrence rates (procedural success)hard clinical
Treatment with statins or RAAS inhibitors does not improve catheter ablation success rates for atrial fibrillation in post-menopausal females.
Main Result
Effect estimate: HR 1.26
Absolute Event Rate: 70.6% vs 68.8%
p-value: p=0.282
Abstract
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.
Cite This Study
Patel et al. (2010) conducted a cohort in Atrial fibrillation (n=372). Statins or RAAS inhibitors vs. No statins or RAAS inhibitors was evaluated on Procedural success (freedom from recurrence) (HR 1.26, p=0.282). Treatment with statins or RAAS inhibitors did not improve catheter ablation success rates compared to controls (70.6% statins, 65.4% RAAS vs 68.8% control; statin HR 1.26, P=0.282).