标题：Renin-Angiotensin System Inhibitors Prevent the Recurrence of Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials
作者：Han, Min; Zhang, Yong; Sun, Shujuan; Wang, Zhongsu; Wang, Jiangrong; Xie, Xinxing; Gao, Mei; Yin, Xiangcui; Hou, Yinglong
作者机构：[Han, Min; Zhang, Yong; Wang, Zhongsu; Wang, Jiangrong; Xie, Xinxing; Gao, Mei; Hou, Yinglong] Shandong Univ, Shandong Prov Qianfoshan Hosp, Dept Card 更多
通讯作者地址：[Hou, YL]Shandong Univ, Shandong Prov Qianfoshan Hosp, Dept Cardiol, Jinan 250014, Peoples R China.
来源：JOURNAL OF CARDIOVASCULAR PHARMACOLOGY
关键词：angiotensin-converting enzyme inhibitor; angiotensin receptor blocker;; atrial fibrillation
摘要：Objective: This study was designed to assess whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could prevent the recurrence of atrial fibrillation (AF).; Methods: A systemic literature search of PubMed, EMBASE, and Cochrane Controlled Trials Register till 2012 was performed to identify randomized controlled trials involving the prevention of recurrence of AF with renin-angiotensin system blockade therapy. Subgroup analysis and meta-regression were performed. Publication bias was checked through funnel plot and Egger's test.; Results: Twenty-one randomized controlled trials including 13,184 patients with AF were identified. Overall, the recurrence of AF was significantly reduced in patients using ACEI/ARBs [odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32-0.56; P < 0.00001], especially both in irbesartan subgroup (OR, 0.38; 95% CI, 0.21-0.68; P = 0.001) and in patients receiving antiarrhythmic drug (AAD) (OR, 0.37; 95% CI, 0.29-0.48; P < 0.00001), and there was no significant difference between ACEIs and ARBs (ACEIs: OR, 0.42; 95% CI, 0.31-0.57 and ARBs: OR, 0.42; 95% CI, 0.31-0.57). Moreover, it was found that the benefits of ACEI/ARBs revealed positive correlation to systolic blood pressure (regression coefficient: -0.0700257, P = 0.000) in no-AAD users.; Conclusions: ACEI/ARBs are effective on the secondary prevention of AF, especially in patients receiving AAD and suffering from hypertension.