https://scholars.lib.ntu.edu.tw/handle/123456789/415336
標題: | Renin-angiotensin-aldosterone blockade reduces atrial fibrillation in hypertrophic cardiomyopathy | 作者: | HSIAO-YU YANG Pau-Chung CHEN LIAN-YU LIN CHIA-TI TSAI HWANG, JUEY-JEN PAU-CHUNG CHEN JIUNN-LEE LIN |
公開日期: | 2018 | 出版社: | BMJ Publishing Group | 卷: | 104 | 期: | 15 | 起(迄)頁: | 1276-1283 | 來源出版物: | Heart | 摘要: | Objectives: Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) is associated with increased mortality, mainly mediated by increased thromboembolic events and progressive heart failure. Many studies suggested inhibition of renin-angiotensin-aldosterone system (RAAS) could reduce new AF in various clinical conditions. However, evidence concerning the effects of RAAS inhibitors on AF prevention remains unclear in HCM. Our study is to investigate whether treatment with ACE inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) could lower the risk of new AF in HCM. Methods: We conducted a retrospective study including subjects diagnosed HCM between January 1997 and December 2013 by using a nationwide database covering almost all Taiwanese from National Health Research Institute. All participants, aged 18 or older, had no ACEIs or ARBs exposure or AF diagnosis before enrolment. Propensity score matching and multivariate Cox hazard regression were employed to estimate the risk of new AF occurrence. Results: Total 18 266 subjects were included in the analysis with median follow-up duration 8.13 years. Patients taking ACEIs or ARBs are associated with lower risk of developing new AF than those without taking neither of medications (3.16% vs 5.65%, relative risk 0.56 (95% CI 0.49 to 0.64), HR 0.572 (95% CI 0.480 to 0.683)). The correlation is more prominent with longer ACEIs or ARBs treatment (HRs from T1 to T3: 0.741, 0.579, 0.337, P<0.001). These results remain consistent after propensity score adjustment. Conclusion: In patients with HCM, lower risk of new AF is observed in patients treated with either ACEIs or ARBs compared with those receiving neither of these medications. ? 2018 Article author(s). All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049140790&doi=10.1136%2fheartjnl-2017-312573&partnerID=40&md5=7cf091abbadd44a8f28a37da2b289e96 https://scholars.lib.ntu.edu.tw/handle/123456789/415336 |
ISSN: | 13556037 | DOI: | 10.1136/heartjnl-2017-312573 | SDG/關鍵字: | angiotensin receptor antagonist; dipeptidyl carboxypeptidase inhibitor; angiotensin receptor antagonist; dipeptidyl carboxypeptidase inhibitor; adult; aged; Article; atrial fibrillation; cardiovascular risk; cohort analysis; comorbidity; controlled study; disease duration; drug effect; female; follow up; human; hypertrophic cardiomyopathy; ICD-9-CM; major clinical study; male; prevalence; priority journal; renin angiotensin aldosterone system; retrospective study; Taiwan; treatment duration; treatment outcome; adolescent; atrial fibrillation; complication; disease free survival; hypertrophic cardiomyopathy; middle aged; mortality; propensity score; survival rate; young adult; Adolescent; Adult; Aged; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Cardiomyopathy, Hypertrophic; Disease-Free Survival; Female; Humans; Male; Middle Aged; Propensity Score; Retrospective Studies; Survival Rate; Taiwan; Young Adult |
顯示於: | 環境與職業健康科學研究所 |
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