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Effect of combined spironolactone-β-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study).
Am J Cardiol. 2010 Dec 01; 106(11):1609-14.AJ

Abstract

Angiotensin II and aldosterone are key factors responsible for the structural and neurohormonal remodeling of the atria and ventricles in patients with atrial fibrillation (AF). The aim of the present study was to evaluate the antiarrhythmic effects of spironolactone compared to angiotensin-converting enzyme inhibitors in patients with recurrent AF. A cohort of 164 consecutive patients (mean age 66 years, 87 men), with an average 4-year history of recurrent AF episodes, was enrolled in a prospective, randomized, 12-month trial with 4 treatment arms: group A, spironolactone, enalapril, and a β blocker; group B, spironolactone and a β blocker; group C, enalapril plus a β blocker; and group D, a β blocker alone. The primary end point of the trial was the presence of symptomatic AF episodes documented on the electrocardiogram. At 3-, 6-, 9-, and 12 months, a significant (p < 0.001) reduction had occurred in the incidence of AF episodes in both spironolactone-treated groups (group A, spironolactone, enalapril, and a β blocker; and group B, spironolactone plus a β blocker) compared to the incidence in patients treated with enalapril and a β blocker (group C) or a β blocker alone (group D). No significant difference was seen in AF recurrences between patients taking spironolactone and a β blocker with (group A) and without (group B) enalapril. No significant differences were found in the systolic or diastolic blood pressure or heart rate among the groups before and after 1 year of follow-up. In conclusion, combined spironolactone plus β-blocker treatment might be a simple and valuable option in preventing AF episodes in patients with normal left ventricular function and a history of refractory paroxysmal AF.

Authors+Show Affiliations

Institute of Cardiology, Warsaw, Poland. rdabrowski45@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21094362

Citation

Dabrowski, Rafal, et al. "Effect of Combined Spironolactone-β-blocker ± Enalapril Treatment On Occurrence of Symptomatic Atrial Fibrillation Episodes in Patients With a History of Paroxysmal Atrial Fibrillation (SPIR-AF Study)." The American Journal of Cardiology, vol. 106, no. 11, 2010, pp. 1609-14.
Dabrowski R, Borowiec A, Smolis-Bak E, et al. Effect of combined spironolactone-β-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study). Am J Cardiol. 2010;106(11):1609-14.
Dabrowski, R., Borowiec, A., Smolis-Bak, E., Kowalik, I., Sosnowski, C., Kraska, A., Kazimierska, B., Wozniak, J., Zareba, W., & Szwed, H. (2010). Effect of combined spironolactone-β-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study). The American Journal of Cardiology, 106(11), 1609-14. https://doi.org/10.1016/j.amjcard.2010.07.037
Dabrowski R, et al. Effect of Combined Spironolactone-β-blocker ± Enalapril Treatment On Occurrence of Symptomatic Atrial Fibrillation Episodes in Patients With a History of Paroxysmal Atrial Fibrillation (SPIR-AF Study). Am J Cardiol. 2010 Dec 1;106(11):1609-14. PubMed PMID: 21094362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of combined spironolactone-β-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study). AU - Dabrowski,Rafal, AU - Borowiec,Anna, AU - Smolis-Bak,Edyta, AU - Kowalik,Ilona, AU - Sosnowski,Cezary, AU - Kraska,Alicja, AU - Kazimierska,Barbara, AU - Wozniak,Jacek, AU - Zareba,Wojciech, AU - Szwed,Hanna, Y1 - 2010/10/14/ PY - 2010/05/01/received PY - 2010/07/11/revised PY - 2010/07/14/accepted PY - 2010/11/25/entrez PY - 2010/11/26/pubmed PY - 2011/1/21/medline SP - 1609 EP - 14 JF - The American journal of cardiology JO - Am J Cardiol VL - 106 IS - 11 N2 - Angiotensin II and aldosterone are key factors responsible for the structural and neurohormonal remodeling of the atria and ventricles in patients with atrial fibrillation (AF). The aim of the present study was to evaluate the antiarrhythmic effects of spironolactone compared to angiotensin-converting enzyme inhibitors in patients with recurrent AF. A cohort of 164 consecutive patients (mean age 66 years, 87 men), with an average 4-year history of recurrent AF episodes, was enrolled in a prospective, randomized, 12-month trial with 4 treatment arms: group A, spironolactone, enalapril, and a β blocker; group B, spironolactone and a β blocker; group C, enalapril plus a β blocker; and group D, a β blocker alone. The primary end point of the trial was the presence of symptomatic AF episodes documented on the electrocardiogram. At 3-, 6-, 9-, and 12 months, a significant (p < 0.001) reduction had occurred in the incidence of AF episodes in both spironolactone-treated groups (group A, spironolactone, enalapril, and a β blocker; and group B, spironolactone plus a β blocker) compared to the incidence in patients treated with enalapril and a β blocker (group C) or a β blocker alone (group D). No significant difference was seen in AF recurrences between patients taking spironolactone and a β blocker with (group A) and without (group B) enalapril. No significant differences were found in the systolic or diastolic blood pressure or heart rate among the groups before and after 1 year of follow-up. In conclusion, combined spironolactone plus β-blocker treatment might be a simple and valuable option in preventing AF episodes in patients with normal left ventricular function and a history of refractory paroxysmal AF. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/21094362/Effect_of_combined_spironolactone_β_blocker_±_enalapril_treatment_on_occurrence_of_symptomatic_atrial_fibrillation_episodes_in_patients_with_a_history_of_paroxysmal_atrial_fibrillation__SPIR_AF_study__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)01507-9 DB - PRIME DP - Unbound Medicine ER -