Blokátory systému renin-angiotenzin-aldosteron u fibrilace síní
| Title in English | Renin-angiotensin-aldosterone system blockers in atrial fibrillation |
|---|---|
| Authors | |
| Year of publication | 2011 |
| Type | Article in Periodical |
| Magazine / Source | Remedia |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | atrial fibrillation; atrial remodelling; upstream therapy; irbesartan; valsartan |
| Description | Atrial fibrillation is the most common sustained arrhythmia. It is associated with increased morbidity, mortality and decreased quality of life. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers reduce morbidity and mortality in patients with heart failure, vascular disease, and hypertension. The TRACE study demonstrated a 55% decrease of atrial fibrillation in patients with chronic heart failure treated with trandolapril. Treatment of hypertension with ACE-I or ARB shows a decrease of new oncet of atrial fibrillation by one third, which was confirmed by the LIFE study – 33% decrease of new onset of atrial fibrillation. In contrast the HOPE and TRANSCEND studies did not confirm any effect of ramipril and/or telmisartan in patients with atrial fibrillation. The ACTIVE I study tested irbesartan versus placebo in 9016 patients with atrial fibrillation. Primary endpoint – myocardial infarction, stroke and vascular death – were not different. The largest post-cardioversion study – GISSI-AF trial – did not confirm the effect on maintenance of sinus rhytm in 1442 patients after cardioversion for atrial fibrillation. The guidelines of the European Society of Cardiology for upstream therapy in atrial fibrillation are included. |
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