Atrial fibrillation: angiotensin sytem blockers for prevention (primary or secondary)
DISEASE INTERVENTION COMPARISON RESULTS
J Am Coll Cardiol. 2005 Jun 7;45(11):1832-9 Meta-Analysis
IN atrial fibrillation The Use of
angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers
As Prevention, Primary
Is better Than
placebo
To reduce the incidence of new onset atrial fibrillation (most cumulated studies: RRR of 28%) and reduce its recurrence after conversion (2 studies)
N Engl J Med. 2011 Mar 10;364(10):928-38 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation The Use of
angiotensin II receptor blockers, irbesartan
As Treatment, Chronic
Is equal Than
placebo
To reduce at 4 years cardiovascular events (stroke, myocardial infarction, or death): 5.4% per years in both groups. Neither it reduced AF recurrences in patients in sinus rhythm at baseline
N Engl J Med. 2009 Apr 16;360(16):1606-17 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, paroxysmal The Use of
angiotensin II receptor blockers (ARB), valsartan
As Prevention, Secondary
Is equal Than
placebo
To reduce recurrences of AF: 51.4% valsartan VS 52% placebo.
J Am Coll Cardiol. 2005 Mar 1;45(5):705-11 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, hypertension, primary The Use of
angiotensin II receptor blockers, losartan
As Treatment, Chronic
Is better Than
beta-blockers
To reduce cardiovascular events (composite of cardiovascular mortality, stroke, and myocardial infarction): 36/171 patients with losartan VS 67/171 patients with B-blokers, at aprox 4 years
J Am Coll Cardiol. 2005 Mar 1;45(5):712-9 Randomized Controlled Trial, Multicenter Study
IN hypertension, primary, ventricular hypertrophy, atrial fibrillation The Use of
angiotensin II receptor blockers, losartan
As Treatment, Chronic
Is better Than
beta-blockers
To prevent development of new-onset atrial fibrillation: AF occurred in 6.8/1,000 person-years with losartan VS 10.1 with B-blockers.