Perindopril for the prevention of atrial fibrillation recurrence after radiofrequency catheter ablation: One-year experience

Wang, Qiqi; Shang, Yunpeng; Wang, Zhen; Zhou, Dongchen; Dong, Fengqin; Qiu, Yan; Li, Haiying; Zheng, Liangrong

doi:10.1016/j.hrthm.2016.06.039

Cited by 12 publications

(13 citation statements)

References 19 publications

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“…Similar evidence has been reported in 256 AF patients to evaluate the effect of perindopril on RAF. In the subgroup of 128 patients treated with placebo, the recurrence rate of atrial fibrillation was 28.5% during the one-year follow-up [ 14 ]. However, another prespecified study from the CABANA Trial showed that 12.6% of ablation patients experienced symptomatic AF, and atrial tachycardia occurred in 36.4% of patients [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Wang

Xiong

Lü

et al. 2022

Oxidative Medicine and Cellular Longevity

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Objectives. The gut microbiota and its metabolites are linked to inflammation and contribute to the progression of atrial fibrillation (AF), but the predictive value of the gut microbiota-derived metabolite lipopolysaccharide (LPS) for AF recurrence (RAF) is unknown. This study is aimed at investigating (1) the correlation between LPS and RAF and (2) its relationship with inflammation and atrial fibrosis. Method. We performed a single-centre retrospective analysis in 159 AF patients. Fasting plasma samples were collected, and an enzyme-linked immunosorbent assay was used to determine the levels of serum LPS, interleukin-6 (IL-6), collagen type-1 C-terminal telopeptide (CITP), and transforming growth factor-β1 (TGFβ1). The cumulative risk for RAF was evaluated with Kaplan–Meier analysis. Cox proportional hazard analysis was carried out to predict the hazard of RAF. The correlations among LPS and IL-6, CITP, TGFβ1, and left atrial diameter (LAD) were analysed by Pearson’s correlation coefficient. Subsequent univariate and multivariable linear regression analyses were carried out to evaluate the connection between clinical variables and Log-LPS. Results. All 159 AF patients were included in this study. The proportion of persistent atrial fibrillation was 40.3%, the mean age was 61.9 ± 10.1 years, the proportion of males was 61.6%, and the mean LPS was 56.5 ± 29.5 pg/mL. After all patients were divided into tertiles according to the circulating LPS level, a total of 44 RAF occurred: 10 in the first tertile, 15 in the second tertile, and 19 in the third tertile (log-rank test P = 0.037 ). Heart failure (hazard ratio 2.029, P = 0.041 ), LAD (hazard ratio 1.064, P = 0.022 ), Log-LPS (hazard ratio 5.686, P = 0.043 ), and CITP (hazard ratio 6.841, P = 0.033 ) independently predicted the risk of RAF. In all patients, univariate analysis showed that heart failure, LAD, hs-CRP, IL-6, CITP, and TGF-β1 were connected with Log-LPS. Multivariate linear regression analysis indicated that IL-6 and hs-CRP were independently and positively connected with Log-LPS. Conclusions. Our results indicated that circulating LPS was a predictor of RAF and may contribute to RAF incidence after ablation by increasing systemic inflammation and atrial fibrosis.

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Section: Discussionmentioning

confidence: 99%

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Wang

Xiong

Lü

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…However, previous studies have yielded contradictory results. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Therefore, an unbiased meta-analysis is needed to establish the clinical role of RASIs. In this study we summarized the currently available evidence about the effect of RASI therapy for the prevention of AF recurrence after ablation, and we discuss the commonalities and differences among these trials.…”

mentioning

confidence: 99%

Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation　― A Meta-Analysis ―

Peng

Luo

et al. 2020

Circ J

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Background: Atrial fibrillation (AF) recurrence remains a tricky problem in patients undergoing ablation. This meta-analysis aimed to summarize the current literature to clarify whether renin-angiotensin system inhibitors (RASIs) prevent AF recurrence after ablation. Methods and Results: Relevant studies were searched on Pubmed and EMBASE through December 2019. Pooled relative risk (RR) of AF recurrence was calculated. Subgroup analyses according to study design, race, and follow-up duration were further performed. A total of 15 studies examining 4,300 patients were included, with 3 randomized controlled trials and 12 cohort studies. Overall analysis showed that RASIs significantly reduced AF recurrence after ablation (RR=0.83; 95% confidence interval (CI) 0.70-0.98, P=0.028; I 2 =68.9%). Subgroup analysis further indicated that positive results were found in randomized controlled trials (RR=0.51, 95% CI 0.37-0.70, P<0.001; I 2 =4%), studies conducted in Asia (RR=0.59, 95% CI 0.46-0.76, P<0.001; I 2 =30.7%), and studies with follow-up duration ≥1 year (RR=0.82, 95% CI 0.70-0.95, P=0.01; I 2 =59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year. Conclusions: RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.

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“…Consequently, seven articles were excluded, of which four did not have a blank control group, one did not have AF endpoint, one was a pretreatment trial, and one was a surgical ablation trial. Thus, 13 studies were eligible for inclusion in the analysis, of which 4 were RCTs [17][18][19][20] and the others were cohort studies. 21,22,[27][28][29][30][31][32][33] Of the 13 enrolled studies, the follow-up duration to detect AF recurrence after the catheter ablation ranged from 3 to 48 months.…”

Section: Resultsmentioning

confidence: 99%

“…In several randomized controlled trials (RCTs), RAS inhibitors were explored that positively reduced AF recurrences after catheter ablation. [17][18][19][20] In contrast, some observational studies suggested that RAS inhibitors did not appear to affect sinus rhythm maintenance following catheter ablation of AF. 21,22) Therefore, our meta-analysis is aimed at exploring the effect of RAS inhibitors on the recurrence of AF after catheter ablation.…”

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confidence: 99%

The Effect of Renin-Angiotensin System Inhibitors on the Recurrence of Atrial Fibrillation After Catheter Ablation

et al. 2020

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Perindopril for the prevention of atrial fibrillation recurrence after radiofrequency catheter ablation: One-year experience

Cited by 12 publications

References 19 publications

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation　― A Meta-Analysis ―

The Effect of Renin-Angiotensin System Inhibitors on the Recurrence of Atrial Fibrillation After Catheter Ablation

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Perindopril for the prevention of atrial fibrillation recurrence after radiofrequency catheter ablation: One-year experience

Cited by 12 publications

References 19 publications

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis

Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation ― A Meta-Analysis ―

The Effect of Renin-Angiotensin System Inhibitors on the Recurrence of Atrial Fibrillation After Catheter Ablation

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Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation　― A Meta-Analysis ―