Atrial fibrillation and inflammation

Table 4 Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and atrial fibrillation

Ref.	Study design	Subjects	Conclusion
Murray et al[76]	Prospective study, retrospective analysis	732 patients; AF rhythm control	No difference in AF recurrence
Madrid et al[71]	Prospective (electrical cardioversion)	154 patients; amiodarone only vs amiodarone + irbesartan	Recurrence of AF lower in irbesartan group
Zaman et al[73]	Prospective (electrical cardioversion)	47 patients; ACEI vs no ACEI group	Number of defibrillation attempts required for successful cardioversion was less in ACEI group
Ueng et al[72]	Prospective (electrical cardioversion)	125 patients; amiodarone only vs amiodarone + enalapril	Enalapril group had decreased rate of recurrence
Pedersen et al[65]	Prospective (post-MI)	1577 patients with LV dysfunction post-MI; trandolapril vs control	Trandolapril reduces AF
SOLVD[66]	Prospective study, but retrospective analysis (heart failure)	374 patients with depressed LV function; enalapril vs control	AF rate lower in ACEI group
Val-HeFT[78]	Prospective study, retrospective analysis (heart failure)	4409 patients with; valsartan vs control	ARB lower incidence of AF
CHARM[77]	Prospective study, retrospective analysis (heart failure)	5518 patients; candesartan vs control	ARB lowers incidence of AF in both normal and depressed ejection fraction
L'Allier et al[79]	Retrospective (hypertension)	5463 patients receiving ACEI vs 5463 patients receiving CCB	The incidence of AF was lower in ACEI group
Miceli et al[80]	Retrospective (post-CABG)	10 023 patients undergoing isolated CABG; ACEI vs non-ACEI	ACEI treatment is associated with an increased risk of post-operative AF
Madrid et al[81]	Meta-analysis	Seven trials involving a total of 24 849 patients	There was a significant statistical difference in the development AF with ACEI/ARB treatment
Kalus et al[82]	Meta-analysis	Four trials	There was a significant statistical difference in the development AF with ACEI/ARB treatment
Anand et al[83]	Meta-analysis	Nine randomized controlled trials	The use of ACEIs and ARBs had an overall effect of 18% risk reduction in new-onset AF across the trials and 43% risk reduction in patients with heart failure
Jibrini et al[84]	Meta-analysis	11 randomized trials	Overall, inhibition of the RAAS reduced the RR of AF by 19%. Reduction in AF was greatest in patients after electrical cardioversion and in patients with heart failure
Healey et al[85]	Meta-analysis	11 randomized trials	Overall, ACEIs and ARBs reduced the relative risk of AF by 28%. Reduction in AF was similar between ACEI and ARB and was greatest in patients with heart failure. Overall, there was no significant reduction in AF in patients with hypertension

AF: Atrial fibrillation; CABG: Coronary artery bypass grafting; ACEI: Angiotensin-converting enzyme inhibitor; ARB: Angiotensin receptor blocker; MI: Myocardial infarction; CCB: Calcium channel blocker; LV: Left ventricle; RAAS: Renin angiotensin aldosterone system; RR: Relative risk.