Key result
Renin-angiotensin system inhibitors reduced atrial fibrillation recurrence after ablation compared to no use (RR 0.85; 95% CI 0.72-0.99; P=0.03), while sacubitril/valsartan was superior to RASIs.
Why the study?
The study was conducted to systematically evaluate the efficacy and safety of renin-angiotensin system inhibitors and sacubitril/valsartan in preventing recurrence after atrial fibrillation ablation.
Do renin-angiotensin system inhibitors or sacubitril/valsartan prevent the recurrence of atrial fibrillation after ablation?
Meta-Analysis
Do renin-angiotensin system inhibitors or sacubitril/valsartan prevent the recurrence of atrial fibrillation after ablation?
Relative Risk: 0.85 (95% CI 0.72–0.99)
p-value: p=0.03
Both RASIs and sacubitril/valsartan can prevent the recurrence of atrial fibrillation after ablation, with sacubitril/valsartan demonstrating greater efficacy than RASIs.
Supports post-ablation RAS inhibitor use to lower AF recurrence; extends evidence favoring sacubitril/valsartan over traditional agents.
To systematically evaluate the efficacy and safety of renin-angiotensin system inhibitors (RASIs) and angiotensin receptor neprilysin inhibitors in preventing the recurrence of atrial fibrillation after atrial fibrillation ablation, we have written this meta-analysis. We systematically searched randomized controlled trials or cohort studies on RASIs and angiotensin receptor neprilysin inhibitor-sacubitril/valsartan (SV) in preventing the recurrence of atrial fibrillation. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Afterward, the meta-analysis was performed using RevMan 5.3 software. This meta-analysis results showed that the recurrence rate of atrial fibrillation after ablation in subjects using RASIs was lower than that in subjects not using them [relative risk = 0.85, 95% confidence interval (CI) (0.72-0.99), P = 0.03]; the recurrence rate in subjects using SV was lower than that in subjects using RASIs [RR= 0.50, 95% CI (0.37-0.68), P < 0.00001]. These results show that both the use of RASIs and SV can prevent the recurrence of after atrial fibrillation ablation, among which the use of SV is more effective.
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Sun et al. (2023) conducted a meta-analysis in Atrial fibrillation. Renin-angiotensin system inhibitors (RASIs) vs. No RASIs was evaluated on Recurrence of atrial fibrillation after ablation (RR 0.85, 95% CI 0.72-0.99, p=0.03). Renin-angiotensin system inhibitors reduced atrial fibrillation recurrence after ablation compared to no use (RR 0.85; 95% CI 0.72-0.99; P=0.03), while sacubitril/valsartan was superior to RASIs.
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