{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:49:14Z","timestamp":1787870954639,"version":"build-2784847793"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"\n Background<\/jats:title>\n \n Mineralocorticoid receptor antagonists (\n MRA<\/jats:styled-content>\n s) have emerged as potential atrial fibrillation (\n AF<\/jats:styled-content>\n ) preventive therapy, but inconsistent results have been reported. We aimed to examine the effects of\n MRA<\/jats:styled-content>\n s on\n AF<\/jats:styled-content>\n occurrence and explore factors that could influence the magnitude of the effect size.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n PubMed, Embase, and Cochrane Central databases were used to search for randomized clinical trials and observational studies addressing the effect of\n MRA<\/jats:styled-content>\n s on\n AF<\/jats:styled-content>\n occurrence from database inception through April 03, 2018. We performed a systematic review and random effects meta\u2010analyses to compute odds ratios with 95%\n CI<\/jats:styled-content>\n s. Meta\u2010regression was then applied to explore the sources of between\u2010study heterogeneity. We included 24 studies, 11 randomized clinical trials and 13 observational cohorts, representing a total number of 7914 patients (median age: 64.2\u00a0years; median left ventricular ejection fraction: 49.7%; median follow\u2010up: 12.0\u00a0months), 2843 (35.9%) of whom received\n MRA<\/jats:styled-content>\n therapy. Meta\u2010analyses showed a significant overall reduction in\n AF<\/jats:styled-content>\n occurrence in the\n MRA<\/jats:styled-content>\n \u2010treated patients versus the control groups (15.0% versus 32.2%; odds ratio, 0.55; 95%\n CI<\/jats:styled-content>\n , 0.44\u20130.70 [\n P<\/jats:italic>\n <0.00001]), with the greatest benefit regarding recurrent\n AF<\/jats:styled-content>\n episodes (\n odds ratio<\/jats:styled-content>\n , 0.42; 95%\n CI<\/jats:styled-content>\n , 0.31\u20130.59 [\n P<\/jats:italic>\n <0.00001]) and with significant heterogeneity among the included studies (\n I<\/jats:italic>\n 2<\/jats:sup>\n =54%;\n P<\/jats:italic>\n =0.0008). Meta\u2010regression analyses showed that effect size was significantly associated with older studies and higher\n AF<\/jats:styled-content>\n occurrence rate in the control groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n MRA<\/jats:styled-content>\n s seem to be effective in\n AF<\/jats:styled-content>\n prevention, especially regarding recurrent\n AF<\/jats:styled-content>\n episodes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013267","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T05:00:23Z","timestamp":1573534823000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Effects of Mineralocorticoid Receptor Antagonists on Atrial Fibrillation Occurrence: A Systematic Review, Meta\u2010Analysis, and Meta\u2010Regression to Identify Modifying Factors"],"prefix":"10.1161","volume":"8","author":[{"given":"Joachim","family":"Alexandre","sequence":"first","affiliation":[{"name":"Department of Pharmacology CHU Caen France"},{"name":"UNICAEN, CHU Caen Medical School Universit\u00e9 Caen Normandie Caen France"},{"name":"Signalisation, \u00e9lectrophysiologie et imagerie des l\u00e9sions d'isch\u00e9mie\u2010reperfusion myocardique Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Dolladille","sequence":"additional","affiliation":[{"name":"Department of Pharmacology CHU Caen France"},{"name":"Department of Cardiology CHU Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Douesnel","sequence":"additional","affiliation":[{"name":"Department of Pharmacology CHU Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonaz","family":"Font","sequence":"additional","affiliation":[{"name":"Department of Pharmacology CHU Caen 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Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital Paris France"},{"name":"INSERM UMR ICAN 1166 Paris France"},{"name":"Faculty of Medicine UPMC Univ Paris 06 Sorbonne Universit\u00e9s Paris France"},{"name":"Institute of Cardiometabolism and Nutrition Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Champ\u2010Rigot","sequence":"additional","affiliation":[{"name":"UNICAEN, CHU Caen Medical School Universit\u00e9 Caen Normandie Caen France"},{"name":"Signalisation, \u00e9lectrophysiologie et imagerie des l\u00e9sions d'isch\u00e9mie\u2010reperfusion myocardique Caen France"},{"name":"Department of Cardiology CHU Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Ollitrault","sequence":"additional","affiliation":[{"name":"Department of Cardiology CHU Caen 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