The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females.
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.
Patel
Dimpi
D
St David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
Mohanty
Prasant
P
Di Biase
Luigi
L
Wang
Yan
Y
Shaheen
Mazen H
MH
Sanchez
Javier E
JE
Horton
Rodney P
RP
Gallinghouse
G Joseph
GJ
Zagrodzky
Jason D
JD
Bailey
Shane M
SM
Burkhardt
J David
JD
Lewis
William R
WR
Diaz
Alberto
A
Beheiry
Salwa
S
Hongo
Richard
R
Al-Ahmad
Amin
A
Wang
Paul
P
Schweikert
Robert
R
Natale
Andrea
A
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
D047228:Angiotensin II Type 1 Receptor Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein