Evidence map›Paper›PMID 38170251›Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2024

Incidence and progression of atrial fibrillation in patients with and without heart failure using mineralocorticoid receptor antagonists: a meta-analysis.

Thalys Sampaio Rodrigues, Levindo Jose Garcia Quarto, Savio Carvalho Nogueira, Anoop N Koshy, Rajiv Mahajan, Prashanthan Sanders, Elif I Ekinci, Louise M Burrell, Omar Farouque, Han S Lim

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Atrial cardiomyopathy revisited-evolution of a concept: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Thalys Sampaio Rodrigues *Department of Cardiology, Austin Health, Melbourne, VIC, Australia.
Levindo Jose Garcia Quarto *Elizabeth Hospital, Boston, MA, USA.
Savio Carvalho NogueiraBeth Israel Deaconess Medical Center, Boston, MA, USA.
Anoop N KoshyDepartment of Cardiology, Austin Health, Melbourne, VIC, Australia.
Rajiv MahajanUniversity of Adelaide, Adelaide, SA, Australia.
Prashanthan SandersUniversity of Adelaide, Adelaide, SA, Australia.
Elif I EkinciDepartment of Medicine, University of Melbourne, Melbourne, VIC, Australia.
Louise M BurrellDepartment of Cardiology, Austin Health, Melbourne, VIC, Australia.
Omar FarouqueDepartment of Cardiology, Austin Health, Melbourne, VIC, Australia.
Han S LimDepartment of Cardiology, Austin Health, Melbourne, VIC, Australia. lim.h@unimelb.edu.au.ORCID http://orcid.org/0000-0002-8532-7891

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMineralocorticoid receptor antagonists (MRAs) have emerged as potential therapy to target the underlying arrhythmogenic substrate in atrial fibrillation (AF). Nevertheless, there have been inconsistent results on the impact of MRAs on AF.

objectiveWe sought to evaluate the effect of MRAs on AF incidence and progression in patients with and without heart failure.

methodsElectronic databases were searched up to September, 2022 for randomized controlled trials (RCTs) that evaluated MRA use and reported AF outcomes. Primary outcome was a composite of new-onset or recurrent AF. Safety outcomes included hyperkalemia and gynecomastia risks. A random-effects meta-analysis estimated pooled odds ratios (OR) and 95% confidence intervals (CI).

results12 RCTs, comprising 11,419 patients treated with various MRAs were included [5960 (52%) on MRA]. On follow-up (6-39 months), 714 (5.5%) patients developed AF. MRA therapy was associated with a 32% reduction in the risk of new-onset or recurrent AF [OR 0.68 (95% CI 0.51-0.92), I

conclusionMRA use is associated with a reduction in AF risk, especially AF progression. A prominent effect is seen in patients with heart failure, further augmented by therapy duration. Prospective trials are warranted to evaluate MRA use as upstream therapy for preventing this common arrhythmia.

Indexed as

Atrial FibrillationDisease ProgressionHeart FailureMineralocorticoid Receptor AntagonistsGlobal HealthHumansIncidenceRandomized Controlled Trials as TopicMineralocorticoid Receptor AntagonistsAtrial fibrillationHeart failureMeta-analysisMineralocorticoid receptor antagonistUpstream therapy

Identifiers

PMID38170251

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.