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Atrial fibrillation

Blockade of the renin–angiotensin system in atrial fibrillation

The effectiveness of existing strategies for management of atrial fibrillation is limited, which has stimulated research into novel therapeutic approaches. A new meta-analysis of randomized controlled trials of inhibitors of the renin–angiotensin system highlights the clinical benefits of these agents and underscores their potential in the prevention and treatment of this disease.

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Figure 1: Possible mechanisms by which ACEIs and ARBs prevent AF.

References

  1. Schneider, M. P. et al. Prevention of atrial fibrillation by renin–angiotensin system inhibition: a meta-analysis. J. Am. Coll. Cardiol. 55, 2299–2307 (2010).

    Article  Google Scholar 

  2. Healey, J. S. et al. Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. J. Am. Coll. Cardiol. 45, 1832–1839 (2005).

    Article  CAS  Google Scholar 

  3. Pedersen, O. D., Bagger, H., Køber, L & Torp-Pedersen, C. The occurrence and prognostic significance of atrial fibrillation/flutter following acute myocardial infarction. TRACE Study group. TRAndolapril Cardiac Evalution. Eur. Heart J. 20, 748–754 (1999).

    Article  CAS  Google Scholar 

  4. Wachtell, K. et al. Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the Losartan Intervention For End Point Reduction in Hypertension (LIFE) study. J. Am. Coll. Cardiol. 45, 712–719 (2005).

    Article  CAS  Google Scholar 

  5. Kozlowski, D. et al. Lone atrial fibrillation: what do we know? Heart 96, 498–503 (2010).

    Article  Google Scholar 

  6. Wachtell, K. et al. In-treatment reduced left atrial diameter during antihypertensive treatment is associated with reduced new-onset atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the LIFE study. Blood Press. 19, 169–175 (2010).

    Article  CAS  Google Scholar 

  7. Ferron, L. et al. Angiotensin II signaling pathways mediate expression of cardiac T-type calcium channels. Circ. Res. 93, 1241–1248 (2003).

    Article  CAS  Google Scholar 

  8. Vermes, E. et al. Enalapril decreases the incidence of atrial fibrillation in patients with left ventricular dysfunction: insight from the Studies Of Left Ventricular Dysfunction (SOLVD) trials. Circulation 107, 2926–2931 (2003).

    Article  Google Scholar 

  9. Disertoni, M. et al. for the GISSI-AF Investigators. Clinical predictors of atrial fibrillation recurrence in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. Am. Heart J. 159, 857–863 (2010).

    Article  Google Scholar 

  10. Kistler, P. M. et al. Absence of acute effects of angiotensin II on atrial electrophysiology in humans. J. Am. Coll. Cardiol. 45, 154–156 (2005).

    Article  Google Scholar 

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Correspondence to Gregory Y. H. Lip.

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Kuzniatsova, N., Shantsila, E. & Lip, G. Blockade of the renin–angiotensin system in atrial fibrillation. Nat Rev Cardiol 7, 428–430 (2010). https://doi.org/10.1038/nrcardio.2010.103

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