The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females

Abstract

Aims To assess whether treatment with statins or renin-angiotensin- aldosterone system (RAAS) inhibitors as potential procedural 'augmenting agents' improved atrial fibrillation (AF) catheter ablation recurrence rates in post-menopausal females (PMFS). Methods and results Five hundred and eighteen consecutive female patients had undergone AF catheter ablation from January 2005 to May 2008. Post-menopausal females were selected and procedure outcomes were compared between cohorts of PMFS treated with statins or RAAS inhibitors to untreated PMFS. Out of 408 PMFS, 36 (8.8) were treated with a combination of RAAS inhibitors and statins, thus were excluded leaving a total of 372 (91.2) patients in the study. Out of 372 patients, 111 (29.8) were on statins (Group 1), 59 (15.9) on RAAS inhibitors (Group 2), and 202 (54.3) without RAAS inhibitors or statins [(Group 3) control population]. Over a mean follow-up time of 24 ± 8.3 (median 25) months, 78 (70.6) in Group 1, 38 (65.4) in Group 2, and 139 (68.8) in Group 3 had procedural success. Statin or RAAS inhibitor use did not predict lower recurrence rates [hazard ratio (HR): 1.26, P = 0.282 and HR: 1.14, P = 0.728, respectively]. When compared with controls, no difference in the cumulative incidence of recurrence was found with statin or RAAS inhibitors use (P = 0.385 and P = 0.761, respectively). Conclusion Treatment with statins or RAAS inhibitors did not improve catheter ablation success rates among PMFS. Thereby, from a clinical standpoint, PMFS should not be started on these treatments as a procedural 'augmenting agent' at this time.