Document Detail


Effect of combined spironolactone-β-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study).
MedLine Citation:
PMID:  21094362     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angiotensin II and aldosterone are key factors responsible for the structural and neurohormonal remodeling of the atria and ventricles in patients with atrial fibrillation (AF). The aim of the present study was to evaluate the antiarrhythmic effects of spironolactone compared to angiotensin-converting enzyme inhibitors in patients with recurrent AF. A cohort of 164 consecutive patients (mean age 66 years, 87 men), with an average 4-year history of recurrent AF episodes, was enrolled in a prospective, randomized, 12-month trial with 4 treatment arms: group A, spironolactone, enalapril, and a β blocker; group B, spironolactone and a β blocker; group C, enalapril plus a β blocker; and group D, a β blocker alone. The primary end point of the trial was the presence of symptomatic AF episodes documented on the electrocardiogram. At 3-, 6-, 9-, and 12 months, a significant (p < 0.001) reduction had occurred in the incidence of AF episodes in both spironolactone-treated groups (group A, spironolactone, enalapril, and a β blocker; and group B, spironolactone plus a β blocker) compared to the incidence in patients treated with enalapril and a β blocker (group C) or a β blocker alone (group D). No significant difference was seen in AF recurrences between patients taking spironolactone and a β blocker with (group A) and without (group B) enalapril. No significant differences were found in the systolic or diastolic blood pressure or heart rate among the groups before and after 1 year of follow-up. In conclusion, combined spironolactone plus β-blocker treatment might be a simple and valuable option in preventing AF episodes in patients with normal left ventricular function and a history of refractory paroxysmal AF.
Authors:
Rafal Dabrowski; Anna Borowiec; Edyta Smolis-Bak; Ilona Kowalik; Cezary Sosnowski; Alicja Kraska; Barbara Kazimierska; Jacek Wozniak; Wojciech Zareba; Hanna Szwed
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-10-14
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1609-14     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Institute of Cardiology, Warsaw, Poland. rdabrowski45@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / administration & dosage,  therapeutic use*
Aged
Aldosterone Antagonists / administration & dosage,  therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use*
Atrial Fibrillation / drug therapy*,  physiopathology
Blood Pressure / drug effects
Dose-Response Relationship, Drug
Drug Therapy, Combination
Electrocardiography / drug effects
Enalapril / administration & dosage,  therapeutic use*
Female
Follow-Up Studies
Heart Rate / drug effects
Humans
Male
Prospective Studies
Spironolactone / administration & dosage,  therapeutic use*
Tachycardia, Paroxysmal / complications,  drug therapy*,  physiopathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Aldosterone Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 52-01-7/Spironolactone; 75847-73-3/Enalapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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