The Relationship between Using Renin-Angiotensin System Inhibitors with Mortality of Atrial Fibrillation: A Systematic Review and Meta-Analysis.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reviews Pub Date : 2024-09-16 DOI:10.2174/011573403X326428240902114410

Reza Faramarz Zadeh, Shahab Masoumi, Negar Jafari, Venus Shahabi Rabori, Saeid Heidari-Soureshjani

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引用次数: 0

Abstract

Background: Atrial fibrillation (AFib) is a highly prevalent cardiac arrhythmia associated with increased mortality in affected persons. Renin-angiotensin system inhibitors (RASIs) have been suggested as potential therapeutic agents for cardiovascular and renal diseases.

Objectives: However, the relationship between RASIs and mortality in AFib patients remains uncertain. Therefore, the present study was designed and implemented for this purpose.

Methods: We searched PubMed/MEDLINE, Embase, Web of Science (WOS), Cochrane Library, and Scopus databases for studies published until 12 February 2024 with relevant keywords. We included studies that reported mortality outcomes in AFib patients treated with RASIs and non-users. The data extraction and quality assessment processes were conducted, and subgroup analyses and sensitivity analyses were done. The data were analyzed by Stata 15 using statistical tests, such as Chi-square and I2 tests.

Results: A total of 15 studies (2007-2024; n=2,178,565 patients) examined the association between RASI drugs and mortality of patients with AFib. The results indicated that compared to the control group, the odds of AFib mortality in the group receiving RASIs were equal to 0.81(95% CI: 0.71-0.92; P-value ≤0.001). The study results did not indicate publication bias (Pvalue= 0.733). During the meta-regression analysis, none of the study variables demonstrated a significant relationship with the observed heterogeneity (P-value > 0.20). Cumulative OR results showed that from 2022 onwards, there was enough evidence to confirm the relationship using RASIs with mortality of patients with AFib.

Conclusion: Therefore, this meta-analysis suggests that the use of RASI drugs is associated with reduced AFib mortality. However, the authors emphasize the need for further high-quality studies and large-scale randomized clinical trials to validate these findings.

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使用肾素-血管紧张素系统抑制剂与心房颤动死亡率的关系：系统回顾与元分析》。

背景：心房颤动（AFib）是一种高发的心律失常，会增加患者的死亡率。肾素-血管紧张素系统抑制剂（RASIs）被认为是治疗心血管和肾脏疾病的潜在药物：然而，RASIs 与心房颤动患者死亡率之间的关系仍不确定。因此，我们设计并实施了本研究：我们检索了 PubMed/MEDLINE、Embase、Web of Science (WOS)、Cochrane Library 和 Scopus 数据库中截至 2024 年 2 月 12 日发表的相关关键词的研究。我们纳入了报告接受 RASIs 治疗和未使用 RASIs 的房颤患者死亡率结果的研究。我们进行了数据提取和质量评估，并进行了亚组分析和敏感性分析。数据使用Stata 15进行分析，并使用Chi-square和I2检验等统计检验：共有15项研究（2007-2024年；n=2,178,565名患者）探讨了RASI药物与心房颤动患者死亡率之间的关系。结果表明，与对照组相比，接受 RASIs 治疗组心房颤动死亡几率为 0.81（95% CI：0.71-0.92；P 值≤0.001）。研究结果未显示发表偏倚（P值= 0.733）。在元回归分析中，没有一个研究变量与观察到的异质性有显著关系（P 值 > 0.20）。累积OR结果显示，从2022年开始，有足够的证据证实RASIs与心房颤动患者死亡率之间的关系：因此，这项荟萃分析表明，RASI 药物的使用与房颤死亡率的降低有关。然而，作者强调需要进一步的高质量研究和大规模随机临床试验来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

10.50%

发文量

117

期刊介绍： Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.