title: The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females.
abstract: OBJECTIVE
  To assess whether treatment with statins or renin-angiotensin-aldosterone system (RAAS) inhibitors as potential procedural 'augmenting agents' improved atrial fibrillation (AF) catheter ablation recurrence rates in post-menopausal females (PMFS).
  
  
  RESULTS
  Five hundred and eighteen consecutive female patients had undergone AF catheter ablation from January 2005 to May 2008. Post-menopausal females were selected and procedure outcomes were compared between cohorts of PMFS treated with statins or RAAS inhibitors to untreated PMFS. Out of 408 PMFS, 36 (8.8%) were treated with a combination of RAAS inhibitors and statins, thus were excluded leaving a total of 372 (91.2%) patients in the study. Out of 372 patients, 111 (29.8%) were on statins (Group 1), 59 (15.9%) on RAAS inhibitors (Group 2), and 202 (54.3%) without RAAS inhibitors or statins [(Group 3) control population]. Over a mean follow-up time of 24 +/- 8.3 (median 25) months, 78 (70.6%) in Group 1, 38 (65.4%) in Group 2, and 139 (68.8%) in Group 3 had procedural success. Statin or RAAS inhibitor use did not predict lower recurrence rates [hazard ratio (HR): 1.26, P = 0.282 and HR: 1.14, P = 0.728, respectively]. When compared with controls, no difference in the cumulative incidence of recurrence was found with statin or RAAS inhibitors use (P = 0.385 and P = 0.761, respectively).
  
  
  CONCLUSIONS
  Treatment with statins or RAAS inhibitors did not improve catheter ablation success rates among PMFS. Thereby, from a clinical standpoint, PMFS should not be started on these treatments as a procedural 'augmenting agent' at this time.
authors.affiliation: St David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
authors.forename: Dimpi
authors.initials: D
authors.lastname: Patel
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Mazen H
authors.initials: MH
authors.lastname: Shaheen
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Horton
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.forename: Jason D
authors.initials: JD
authors.lastname: Zagrodzky
authors.forename: Shane M
authors.initials: SM
authors.lastname: Bailey
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.forename: William R
authors.initials: WR
authors.lastname: Lewis
authors.forename: Alberto
authors.initials: A
authors.lastname: Diaz
authors.forename: Salwa
authors.initials: S
authors.lastname: Beheiry
authors.forename: Richard
authors.initials: R
authors.lastname: Hongo
authors.forename: Amin
authors.initials: A
authors.lastname: Al-Ahmad
authors.forename: Paul
authors.initials: P
authors.lastname: Wang
authors.forename: Robert
authors.initials: R
authors.lastname: Schweikert
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D002097:C-Reactive Protein / Q000378:metabolism; D017115:Catheter Ablation / Q000379:methods* / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D017698:Postmenopause; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein