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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

The impact of suppressing the renin-angiotensin system on atrial fibrillation

Review published: 2006.

Bibliographic details: Kalus J S, Coleman C I, White C M.  The impact of suppressing the renin-angiotensin system on atrial fibrillation. Journal of Clinical Pharmacology 2006; 46(1): 21-28. [PubMed: 16397280]

Quality assessment

The authors concluded that angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers prevent the development of new-onset atrial fibrillation (AF), improve the likelihood of successful direct current cardioversion (DCC), and prevent recurrence of AF after DCC. Given the methodological limitations and the unknown quality of the included studies, the results should be interpreted with caution. Full critical summary

Abstract

Atrial fibrillation is very common in the United States. After a search of Medline, EMBASE, and CINAHL, 4 trials evaluating inhibitors of the renin-angiotensin system were identified for prevention of new-onset atrial fibrillation, facilitation of electrical cardioversion of atrial fibrillation, and prevention of atrial fibrillation recurrence after electrical cardioversion. A meta-analysis was performed using a random-effects model. Use of an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-receptor blocker (ARB) was associated with a reduction in new-onset atrial fibrillation (OR [95% CI] = 0.51 [0.36-0.72]), a lower failure rate of electrical cardioversion of atrial fibrillation (0.47 [0.24-0.92]), and a lower rate of recurrence of atrial fibrillation after electrical cardioversion (0.39 [0.20-0.75]). With the exception of the new-onset atrial fibrillation analysis, these findings were not associated with statistical heterogeneity. These hypothesis-generating data suggest that inhibitors of the renin-angiotensin system may provide benefit across the spectrum of atrial fibrillation.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2013 University of York.

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