单位:[1]Huazhong Univ Sci & Technol,Inst Hypertens,Tongji Hosp,Tongji Med Coll,Dept Internal Med,Wuhan 430030,Peoples R China内科学系大内科高血压病研究所华中科技大学同济医学院附属同济医院心血管内科[2]Univ British Columbia, Grad Program Neurosci, Coll Interdisciplinary Studies, Vancouver, BC V5Z 1M9, Canada[3]Univ British Columbia, Dept Med, Div Neurol, Vancouver, BC, Canada
Background: Impact of atrial fibrillation on clinical outcomes is well recognized, and application of renin-angiotensin-aldosterone system (RAAS) blockers for the prevention of atrial fibrillation (AF) is a theoretically appealing concept. However, clinical trials have yielded inconsistent results. Methods: A pooled study of 26 randomized controlled trials (RCTs) assessing the efficacy of RAAS blockers on AF prophylaxis was performed. Results: A total of 28 reports from 26 randomized controlled trials enrolled 165 387 patients, with an overall 24% reduction in the incidence of AF (odds ratio [OR]: 0.76, 95% confidence interval [CI]: 0.68-0.85], P = .000). Forty-nine percent reduction in the incidence of AF (OR: 0.51, 95% CI: 0.30-0.85, P = .010) in systolic heart failure was observed, whereas no significant effect was observed in patients with diastolic heart failure, postmyocardial infarction, and high cardiovascular disease risk. There was a 19% (OR: 0.81, 95% CI: 0.67-1.00, P = .037) reduction in new-onset and 54% (OR: 0.46, 95% CI: 0.33-0.62, P = .000) reduction in recurrent AF in hypertensive patients with 39% (OR: 0.61, 95% CI: 0.44-0.84, P = .003) risk reduction against calcium blockers and 41% (OR: 0.59, 95% CI: 0.44-0.80, P = .001) risk reduction against beta blockers. Angiotensin-receptor blocker appeared marginally superior to angiotensin-converting enzyme inhibitor in primary and secondary prevention. Conclusion: This study suggests that RAAS blockade effectively suppresses AF in systolic heart failure, and hypertensives derive greater benefit against new-onset and recurrent AF compared to beta blockers, calcium channel blockers, and diuretics.
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外文
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出版当年[2015]版:
大类|3 区医学
小类|3 区药学4 区心脏和心血管系统
最新[2025]版:
大类|4 区医学
小类|3 区药学4 区心脏和心血管系统
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出版当年[2014]版:
Q3PHARMACOLOGY & PHARMACYQ3CARDIAC & CARDIOVASCULAR SYSTEMS
第一作者单位:[1]Huazhong Univ Sci & Technol,Inst Hypertens,Tongji Hosp,Tongji Med Coll,Dept Internal Med,Wuhan 430030,Peoples R China
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推荐引用方式(GB/T 7714):
Chaugai Sandip,Meng Wen Yeng,Sepehry Amir Ali.Effects of RAAS Blockers on Atrial Fibrillation Prophylaxis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials[J].JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS.2016,21(4):388-404.doi:10.1177/1074248415619490.
APA:
Chaugai, Sandip,Meng, Wen Yeng&Sepehry, Amir Ali.(2016).Effects of RAAS Blockers on Atrial Fibrillation Prophylaxis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS,21,(4)
MLA:
Chaugai, Sandip,et al."Effects of RAAS Blockers on Atrial Fibrillation Prophylaxis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials".JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS 21..4(2016):388-404