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Review: angiotensin converting enzyme inhibitors and angiotensin receptor blockers prevent atrial fibrillation

Clinical impact ratings Internal medicine Cardiology

Key Words: atrial fibrillation • angiotensin-converting enzyme inhibitors • angiotensin II type 1 receptor blockers

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Medline and EMBASE/Excerpta Medica (from 1980), abstracts of scientific meetings (past 4 y), reference lists of relevant articles, and contact with authors of appropriate trials that did not publish AF outcomes.

Study selection and assessment: randomised controlled trials (RCTs) with a parallel design, published in English, that compared an ACE inhibitor or ARB with placebo, no treatment, or an alternate treatment and recorded AF as an outcome. 2 reviewers blindly and independently assessed studies for inclusion.

Outcomes: new or recurrent AF.

MAIN RESULTS
11 RCTs (n = 56 309) met the selection criteria. ACE inhibitors and ARBs reduced the risk of new or recurrent AF by 28%, with similar benefits for the 2 types of drugs (table). Treatment with these drugs reduced the risk of AF in patients with heart failure or previous electrical cardioversion for AF, but not in patients with hypertension or previous myocardial infarction, except those . . . [Full text of this article]

V J Karthikeyan, MRCP, Gregory Y H Lip, MD

City Hospital
Birmingham, UK