Backround: Recent observations indicate that ACE inhibitors and ARBs prevent the development of new-onset AF, improve the likelihood of successful DCC, and prevent recurrence of AF after DCC.
Objective: In our study, we tried to find the impact of RAS blockade on patient‘s mortality.
Method: Retrospective study of medical records of all patiens with AF hospitalized at the Department of Internal Cardiology Medicine of Faculty hospital in Brno in 15 month period (10/2004-12/2005), all together 827 patients (451 men, 377 women) with average age of 70 years and any kind of AF. We divided them in two groups, the first one medicating ACEI/ARBs (n= 559), the latter without these drugs, n=268. We compared the common risk factors and one-year mortality between these groups.
Results: Patients using ACEI/ARBs were older (average age 71,5 compared to 66,5 years, p<0,0001), in higher NYHA class, (average 2,0 to 1,6, p<0,0001), more often suffered from chronic heart failure (32,2% vs.12,7%, p<0,0001), coronary artery disease (61,5% vs 35%, p<0,0001), diabetes (29,7% vs. 17,5%, p<0,0002), hypertension (83% vs. 51%, p<0,0001), more of them having stroke in anamnesis (20,6% vs.13%, p<0,01), their average ejection fraction of left ventricle was lower (49,4 vs. 56,2, p<0,0001). We found no statistical difference in prevalence of diastolic dysfunction, in serum levels of creatinine, uric acid, cholesterol, triglycerides and haemoglobin. The one-year mortality of the first group was 10,7% (60 patients of 559), in the second group 16% (43 of 268), p=0,0304.
Conclusion: The mortality of patients treated with ACEI/ARBs was significantly lower despite more risk factors and comorbitities than in the group of patients without RAS blockade.
|
1 online
