Efficacy and safety of sacubitril/valsartan in the treatment of atrial fibrillation after ablation:a Meta-analysis
BI Longfei
LIU Yao
YU Dan
DAN Xuechuan
LI Kui
Abstract：Objective To systematically evaluate the efficacy and safety of sacubitril/valsartan(SV)in the treatment of atrial fibrillation(AF).Methods Computerized searches of PubMed,Embase,Web of Science,The Cochrane Library,CNKI,WanFang Data and VIP from the time of inception to April 27,2024 were conducted.Literature screening,data extraction and quality assessment were conducted independently by two researchers.Meta-analysis was performed using RevMan 5.4 software.Results A total of 10 studies were included,including 8 randomized controlled trials,2 cohort studies,with a cumulative total of 1 355 patients.The test group was treated with conventional therapy+SV,and the control group was treated with conventional therapy or conventional therapy+angiotensin converting enzyme inhibitor(ACEI)/angiotensin receptor blockers(ARB).The results of the Meta-analysis showed that in patients with AF who converted to sinus rhythm after undergoing radiofrequency catheter ablation,compared with the conventional therapy+ACEI/ARB,the conventional therapy+SV was able to significantly reduce the recurrence rate of AF[OR=0.35,95％CI(0.26,0.46),P＜0.001],reduced left atrial diameter[MD=-3.26,95％CI(-4.81,-1.70),P＜0.001],and left atrial volume index[MD=-6.50,95％CI(-8.76,-4.25),P＜0.001],increase the level of left ventricle ejection fraction[MD=3.79,95％CI(2.17,5.41),P＜0.001],decreased levels of N-terminal pro-brain natriuretic peptide[MD=-106.49,95％CI(-134.71,-78.27),P＜0.001],reduce the incidence of adverse drug reactions[OR=0.48,95％CI(0.26,0.86),P=0.01].However,the efficacy in lowering blood pressure was similar in both groups.Conclusion The application of conventional therapy+SV after ablation in patients with AF was more effective in reducing the recurrence rate of AF and improving left heart function compared with conventional therapy or conventional therapy+ACEI/ARB,while there was no significant difference in the magnitude of blood pressure reduction,this conclusion need to be justified by more high-quality research.
Keywords：Sacubitril/valsartanAtrial fibrillationAngiotensin converting enzyme inhibitorsAngiotensin receptor blockersAblationMeta-analysis
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：11( 916-926 )