Gang Huang and Jun-bo Xu contributed equally to this work and are co-first authors.
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers decrease the incidence of atrial fibrillation: a meta-analysis
Article first published online: 20 JAN 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 7, pages 719–733, July 2011
How to Cite
Huang, G., Xu, J.-b., Liu, J.-x., He, Y., Nie, X.-l., Li, Q., Hu, Y.-m., Zhao, S.-q., Wang, M., Zhang, W.-y., Liu, X.-r., Wu, T., Arkin, A. and Zhang, T.-j. (2011), Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers decrease the incidence of atrial fibrillation: a meta-analysis. European Journal of Clinical Investigation, 41: 719–733. doi: 10.1111/j.1365-2362.2010.02460.x
- Issue published online: 9 JUN 2011
- Article first published online: 20 JAN 2011
- Received 19 December 2009; accepted 9 December 2010
- Angiotensin II type 1 receptor blockers;
- angiotensin-converting enzyme inhibitors;
- atrial fibrillation
Eur J Clin Invest 2011; 41 (7): 719–733
Background There is not a general agreement regarding antiarrhythmic effects on atrial fibrillation (AF) of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). This study was to assess whether ACEIs and ARBs could decrease the incidence of AF.
Materials and methods Medline, Embase and Cochrane Library databases were searched for trials reported from 1950 to May 2009. Search terms included ‘randomized controlled trial (RCT), controlled clinical trials, random allocation’ and medical subject headings that included all spellings of ACEIs and ARBs agents, ‘atrial fibrillation’ and ‘atrial flutter’. Randomized, controlled human trials of ACEIs or ARBs reporting AF were included. Data were extracted independently by two reviewers using a predefined data extraction sheet, including study quality indicators. Meta-analysis and subgroup analyses were carried out with a random effects model.
Results Twenty-one trials including 91 381 patients and 5730 AF events were identified. Overall, ACEIs/ARBs reduced the relative risk (c) of AF by 25%. In primary and secondary prevention, ACEIs/ARBs decreased the incidence of AF by 24% and 27%, respectively. Patients with hypertension (RR: 0·71, 95%CI: 0·54–0·92), patients with chronic heart failure (RR: 0·58, 95%CI: 0·39–0·87) and those with AF (RR: 0·71, 95%CI: 0·52–0·96) benefited from ACEIs/ARBs treatment.
Conclusions ACEIs/ARBs are effective for primary prevention and secondary prevention of AF. They decrease the incidence of AF especially in patients with hypertension, patients with chronic heart failure and those with AF.