Why the study?
Do ACEIs or ARBs prevent the development of atrial fibrillation?
Do ACEIs or ARBs prevent the development of atrial fibrillation?
ACEIs and ARBs significantly reduce the risk of developing atrial fibrillation, with greater effects seen for recurrent AF and in patients receiving amiodarone.
ACEIs/ARBs merit consideration for AF prevention; confirms and extends meta-analytic support for renin-angiotensin blockade.
Current evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) have emerged as novel drugs for preventing the development of atrial fibrillation (AF). A meta-analysis was performed of 26 randomized controlled clinical trials evaluating the effect of ACEIs or ARBs on the prevention of AF. Overall, ACEIs and ARBs revealed statistically significant preventive effects on AF (odds ratio (OR), 0.65; 95% confidence interval (CI), 0.55-0.76). The preventive effect was similar in the two classes of drugs (ACEI: OR, 0.68; ARB: OR, 0.69). ACEIs and ARBs showed greater preventive effects on recurrent AF (OR, 0.45; 95% CI, 0.31-0.65) than on new-onset AF (OR, 0.80; 95% CI, 0.70-0.92). Prevention was greatest in patients with AF who were receiving amiodarone as a basic treatment drug (OR, 0.35; 95% CI, 0.26-0.48). In patients with heart failure, there appeared to be a large effect (OR, 0.497), but the credible interval (CrI) limits were wide (95% CrI, 0.187-1.161).
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Zhang et al. (2010) studied this question.
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