{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:05:00Z","timestamp":1776866700450,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,2,26]],"date-time":"2007-02-26T00:00:00Z","timestamp":1172448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Internal Medicine"],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p><jats:bold>Background.\u2002<\/jats:bold> The renin\u2010angiotensin\u2010aldosterone\u2010system (RAAS) plays an important role in atrial fibrillation (AF). Evidence shows that blocking the RAAS with angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) has a definite role in preventing new onset AF and in maintaining sinus rhythm in recurrent AF. Our aim was to determine if ACEI\/ARB treatment was associated with clinical outcomes [stroke\/systemic embolic events (SEE), mortality] in a controlled, anticoagulated AF population.<\/jats:p><jats:p><jats:bold>Methods.\u2002<\/jats:bold> An ancillary retrospective cross\u2010sectional and longitudinal analysis of participants in the Stroke Prevention using an ORal Thrombin Inhibitor in AF (SPORTIF) III and V trials, in relation to use (or nonuse) of ACEI\/ARBs.<\/jats:p><jats:p><jats:bold>Results.\u2002<\/jats:bold> Rates of stroke\/SEEs, mortality or major bleeding were no different between users and nonusers in the whole cohort, or in relation to the presence\/absence of hypertension, coronary artery disease and previous stroke\/transient ischaemic attack, nor amongst those aged &lt;75\u2003years. Patients aged \u226575\u2003years taking ACEIs or ARBs had lower mortality (HR 0.71, 95% CI 0.52\u20130.95), but no significant influence on other end\u2010points was noted. Diabetics and those with left ventricular dysfunction on ximelagatran had a higher odds ratio of abnormal liver enzyme levels. There was no apparent benefit of ACEIs or ARBs on other event rates.<\/jats:p><jats:p><jats:bold>Conclusions.\u2002<\/jats:bold> This analysis from two large randomized trials of anticoagulation has not demonstrated a significant benefit of ACEI or ARB use amongst AF patients, except amongst elderly subjects.<\/jats:p>","DOI":"10.1111\/j.1365-2796.2007.01780.x","type":"journal-article","created":{"date-parts":[[2007,2,26]],"date-time":"2007-02-26T19:13:52Z","timestamp":1172517232000},"page":"577-586","source":"Crossref","is-referenced-by-count":15,"title":["Angiotensin converting enzyme inhibitor and angiotensin receptor blockade use in relation to outcomes in anticoagulated patients with atrial fibrillation"],"prefix":"10.1111","volume":"261","author":[{"given":"G. Y. 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