The effect of aldosterone antagonists for ventricular arrhythmia: a meta-analysis.
BACKGROUND
Sudden cardiac death (SCD) from cardiac arrest, one of the most common types of cardiac-related death, is most often triggered by ventricular arrhythmia (VA). It has been reported that aldosterone antagonists (AAs) have the benefit of reducing SCD in patients with heart failure (HF). It also has been indicated in animal experiments and clinical trials that AAs may have an antiarrhythmic effect.


OBJECTIVE
AAs have an effect on VA in patients with HF or coronary artery disease.


METHODS
We searched the Cochrane Central Register of Controlled Trials, PubMed, Current Controlled Trials, and the National Research Register, and identified randomized controlled trials on the effect of AAs on VA.


RESULTS
All together, 7 trials with a total of 8635 patients were identified and extracted. AAs reduced the risk of SCD in patients with HF by 21% (relative risk [RR]: 0.79, 95% confidence interval [CI]: 0.67-0.93). AAs significantly reduced the episodes of ventricular premature complexes (mean difference 705 ± 646 episodes per 24 hours). Risk of ventricular tachycardia was reduced by 72% (RR: 0.28, 95% CI: 0.10-0.77).


CONCLUSIONS
The additional administration of AAs in patients with HF or coronary artery disease shows a benefit in reducing the risk of SCD and may also be effective for reducing episodes of ventricular premature complexes and ventricular tachycardia.
Wei
Jiafu
J
Cardiology Department, West China Second University Hospital, Sichuan University, Sichuan, China.
Ni
Juan
J
Huang
Dejia
D
Chen
Mao
M
Yan
Shaodi
S
Peng
Yong
Y
D016001:Confidence Intervals; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004232:Diuretics / Q000627:therapeutic use*; D000077545:Eplerenone; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D012306:Risk; D013148:Spironolactone / Q000031:analogs & derivatives / Q000627:therapeutic use*
D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone