title: Association between the use of renin-angiotensin system blockers and development of in-hospital atrial fibrillation in patients with ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST-segment elevation myocardial infarction (STEMI). We evaluated the association between use of previous angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers (renin-angiotensin system [RAS] blockers) and started RAS blockers after MI and development of AF in patients presenting with acute STEMI.
  
  
  METHODS
  This retrospective study enrolled 1000 patients with acute STEMI who were admitted to the coronary care unit. Patients were divided into groups according to the use of RAS blockers before MI and development of AF rates was compared. Predictors of AF were determined by multiple logistic regression analysis.
  
  
  RESULTS
  Of the 1000 patients presenting with STEMI, 247 received and 753 did not receive RAS blockers. The incidence of AF was 7.9%. The incidence of AF in patients receiving RAS blockers and did not receiving RAS blockers before MI were similar (5.7% vs. 8.6% respectively, P=0.13). On the other hand, AF rate was lower in patients in whom RAS blockers were administered during MI as compared to those in whom these agents were not administered (7.2% vs. 28.6%, P<0.001). Multiple regression analysis results showed that administration of RAS blockers or statins during hospitalization and left atrial diameter were associated with development of AF in patients with acute STEMI.
  
  
  CONCLUSIONS
  Previous therapy with RAS blockers does not reduce the incidence of AF in STEMI. Administration of RAS blockers at the hospital may decrease the AF rate in STEMI.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. Electronic address: dr.akifarslan@hotmail.com.
authors.forename: Akif
authors.initials: A
authors.lastname: Arslan
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aksoy
authors.affiliation: Department of Family Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Bahriye
authors.initials: B
authors.lastname: Arslan
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Hasan Aydin
authors.initials: HA
authors.lastname: Bas
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Dogan
authors.initials: D
authors.lastname: Erdogan
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Varol
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Dogan
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012084:Renin-Angiotensin System; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000150:complications*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Atrial fibrillation; Myocardial infarction; Renin-angiotensin system