Interv Akut Kardiol. 2009;8(6):325-327

ACTIVE I and upstream therapy

Jindřich Špinar, Růžena Lábrová

Interní kardiologická klinika FN a LF MU, Brno

Atrial fibrillation is the most common sustained arrhythmia. It is associated with increased morbidity and mortality and decreased quality

of life. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers reduce morbidity and mortality in patients with

heart failure, vascular disease, and hypertension. The renin-angiotensin-aldosterone system (RAAS) is involved in the pathophysiology

of atrial fibrillation, and that RAAS blockade improves outcomes in atrial fibrillation merits plausibility. There are now mounting data to

suggest that modulation of the renin-angiotensin-aldosterone system might have an important role in the prevention of atrial fibrillation

and its consequences. The ACTIVE I study tested irbesartan versus placebo in 9 016 patients with atrial fibrilation and BPs ≥ 110 mm Hg.

Irbesartan lowerd BPs by 6.84 mm Hg, placebo 3.93 mm Hg. Primary endpoint – myocardial infarction, stroke and vascular death were

not different 963 first events in both arms, 1 100 resp 1 122 repetitive events (irbesartan vs placebo p = 0.846)

Keywords: atrial fibrillation, atrial remodelling, upstream therapy, ACTIVE I, irbesartan

Published: December 12, 2009  Show citation