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
Sandip ChaugaiAmir Ali Sepehry

Abstract

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. A pooled study of 26 randomized controlled trials (RCTs) assessing the efficacy of RAAS blockers on AF prophylaxis was performed. 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 a...Continue Reading

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Citations

Jul 14, 2018·Free Radical Research·Panagiotis KorantzopoulosTong Liu
Mar 27, 2019·Journal of the American Heart Association·Arthur Mark Richards
Feb 20, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Dimpi PatelJawed Fareed
Jun 27, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Erik HolzwirthPetra Büttner
Dec 14, 2017·Herzschrittmachertherapie & Elektrophysiologie·Alicja BukowskaAndreas Goette
Oct 20, 2018·Frontiers in Physiology·Nathan C DenhamKatharine M Dibb
Aug 4, 2019·Heart Failure Reviews·Annamaria MascoloFrancesco Rossi
Feb 13, 2021·Journal of Cellular and Molecular Medicine·Jin MaShiyu Ma
Feb 1, 2021·Cardiac Electrophysiology Clinics·Dennis H LauMohammad Shenasa
Mar 7, 2020·The American Journal of Cardiology·Elsayed Z SolimanDavid M Herrington
Aug 31, 2021·Heart and Vessels·Erik HolzwirthPetra Büttner
Sep 18, 2021·Cardiovascular Drugs and Therapy·Martin H StraussKrzysztof Narkiewicz

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Software Mentioned

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