Kalus James S, Coleman Craig I, White C Michael
Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Suite 2190, Detroit, MI 48201, USA.
J Clin Pharmacol. 2006 Jan;46(1):21-8. doi: 10.1177/0091270005283284.
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.
心房颤动在美国非常常见。在检索了医学文献数据库（Medline）、荷兰医学文摘数据库（EMBASE）和护理学与健康领域数据库（CINAHL）之后，确定了4项评估肾素-血管紧张素系统抑制剂的试验，这些试验旨在预防新发心房颤动、促进心房颤动的电复律以及预防电复律后心房颤动的复发。使用随机效应模型进行了荟萃分析。使用血管紧张素转换酶（ACE）抑制剂或血管紧张素受体阻滞剂（ARB）与新发心房颤动减少相关（比值比[95%可信区间]=0.51[0.36-0.72]），心房颤动电复律失败率较低（0.47[0.24-0.92]），电复律后心房颤动复发率较低（0.39[0.20-0.75]）。除了新发心房颤动分析外，这些结果不存在统计学异质性。这些产生假设的数据表明，肾素-血管紧张素系统抑制剂可能在心房颤动的各个方面都有获益。
