title: Age and CHADS2 Score Predict the Effectiveness of Renin-Angiotensin System Blockers on Primary Prevention of Atrial Fibrillation.
abstract: Renin-angiotensin system (RAS) blockers have potential protective effects against atrial fibrillation (AF). The purpose of this study was to determine if patient characteristics and underlying co-morbidities could predict the efficacy of RAS blockers in AF prevention. Patients aged ≥ 45 years with hypertension were identified from the Taiwan National Health Insurance Research Database. After propensity-score matching, a total of 22,324 patients were included in this study. Risk of new-onset AF in RAS blockers users and non-users was estimated. During up to 10 years of follow-up, 1,475 patients experienced new-onset AF. Overall, RAS blockers reduced the risk of AF by 36% (adjusted HR 0.64; 95% CI 0.58 to 0.71; p < 0.001). Subgroup analysis showed that RAS blockers use was beneficial for AF prevention in patients aged ≥ 55 years or with a CHADS2 score of 1, 2, or 3. The therapy provided no obvious beneficial effect for AF prevention in those aged less than 55 years or with a CHADS2 score ≥ 4. In conclusion, RAS blockers reduced the risk of new-onset AF in patients aged ≥ 55 years or with a CHADS2 score of 1, 2, or 3, but not in patients aged less than 55 years or with a CHADS2 score ≥ 4.
authors.affiliation: 1] Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan [2] Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan [3] Department of Nutrition, Hungkuang University, Taichung, Taiwan.
authors.forename: Chen-Ying
authors.initials: CY
authors.lastname: Hung
authors.affiliation: 1] Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan [2] Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Hsieh
authors.affiliation: 1] Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan [2] Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.affiliation: 1] Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan [2] Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan [3] School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Huang
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
authors.affiliation: 1] Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan [2] Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Tsu-Juey
authors.initials: TJ
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012306:Risk
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors