Journal ArticleDOI
Primary and secondary prevention of atrial fibrillation with statins and polyunsaturated fatty acids: review of evidence and clinical relevance
TLDR
A contemporary evidence-based insight is provided into the possible preventative and reverse remodeling role of statins and polyunsaturated fatty acids in AF.Abstract:
Atrial fibrillation (AF) is an increasingly common arrhythmia that now stands at epidemic proportion, with more than 2.3 million people affected in the USA and over 4.5 million people affected in Western Europe. AF is an expression of underlying heart disease and is increasingly associated with hypertension, congestive heart failure, and ischemic heart disease. It is also a progressive disease secondary to continuous structural remodeling of the atria, which relates to AF itself, to changes associated with aging and to progression of the underlying heart disease. Traditionally, AF has been addressed only after it has already presented with pharmacological and nonpharmacological therapies designed for rhythm or rate control (secondary prevention). Although secondary prevention is the most feasible approach at present, the concept of primary prevention of AF with therapies aimed at preventing the development of substrate and correcting the risk factors for AF has emerged as a strategy, which is likely to produce a larger effect in the general population. Recent experiments provided new insights into AF pathophysiology, which generated background for new mechanism-based therapies. Agents targeting inflammation, oxidative injury, atrial myocyte metabolism, extracellular matrix remodeling, and fibrosis have theoretical advantages as novel therapeutic strategies. In this respect, drugs that are not traditionally antiarrhythmic such as angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, aldosterone antagonists, statins, and omega-3 polyunsaturated fatty acids have shown an antiarrhythmic potential in addition to any treatment effect on the underlying disease. These agents are thought to have an advantage of targeting both the occurrence and progression of the substrate for AF, thus, providing primary and secondary prevention of the arrhythmia. Although first experimental and hypothesis-generating small clinical studies or retrospective analyses have been encouraging, several larger, properly designed, prospective trials have not confirmed earlier observations. This review provides a contemporary evidence-based insight into the possible preventative and reverse remodeling role of statins and polyunsaturated fatty acids in AF.read more
Citations
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Journal ArticleDOI
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society
Craig T. January,L. Samuel Wann,Joseph S. Alpert,Hugh Calkins,Joaquin E. Cigarroa,Joseph C. Cleveland,Jamie B. Conti,Patrick T. Ellinor,Michael D. Ezekowitz,Michael E. Field,Katherine T. Murray,Ralph L. Sacco,William G. Stevenson,Patrick J. Tchou,Cynthia M. Tracy,Clyde W. Yancy +15 more
TL;DR: This document summarizes current research, plans, and recommendations for future research, as well as providing a history of the field and some of the techniques used, currently in use, at the National Institutes of Health.
Journal ArticleDOI
Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)
A. John Camm,Paulus Kirchhof,Irene Savelieva,Isabelle C. Van Gelder,Gerhard Hindricks,Ottavio Alfieri,Johan De Sutter,Andreas Goette,Stefan H. Hohloser,Piotr Ponikowski,Frans H. Rutten +10 more
TL;DR: Estimates of expected health outcomes for larger societies are included, where data exist, and the level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to pre-defined scales.
Journal ArticleDOI
Guidelines for the management of atrial fibrillation
A. John Camm,Paulus Kirchhof,Gregory Lip,Ulrich Schotten,Irene Savelieva,Sabine Ernst,Isabelle C. Van Gelder,Nawwar Al-Attar,Gerhard Hindricks,Bernard Prendergast,Hein Heidbuchel,Ottavio Alfieri,Annalisa Angelini,Dan Atar,Paolo Colonna,Raffaele De Caterina,Johan De Sutter,Andreas Goette,Bulent Gorenek,Magnus Heldal,Stefan H. Hohloser,Philippe Kolh,Jean-Yves Le Heuzey,Piotr Ponikowski,Frans H. Rutten,Alec Vahanian,Angelo Auricchio,Jeroen J. Bax,Claudio Ceconi,Veronica Dean,Gerasimos Filippatos,Christian Funck-Brentano,Richard Hobbs,Peter Kearney,Theresa McDonagh,Bogdan A. Popescu,Zeljko Reiner,Udo Sechtem,Per Anton Sirnes,Michal Tendera,Panos E. Vardas,Petr Widimsky,Vazha Agladze,Etienne Aliot,Tosho L. Balabanski,Carina Blomström-Lundqvist,Alessandro Capucci,Harry J.G.M. Crijns,Björn Dahlöf,Thierry Folliguet,Michael Glikson,Marnix Goethals,Dietrich C. Gulba,Siew Yen Ho,Robert J.M. Klautz,Sedat Kose,John McMurray,Pasquale Perrone Filardi,Pekka Raatikainen,Maria Jesus Salvador,Martin J. Schalij,Alexander Shpektor,João de Sousa,Janina Stepinska,Hasso Uuetoa,José Luis Zamorano,Igor Zupan +66 more
TL;DR: Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means.
Journal ArticleDOI
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary
Craig T. January,L. Samuel Wann,Joseph S. Alpert,Hugh Calkins,Joaquin E. Cigarroa,Joseph C. Cleveland,Jamie B. Conti,Patrick T. Ellinor,Michael D. Ezekowitz,Michael E. Field,Katherine T. Murray,Ralph L. Sacco,William G. Stevenson,Patrick J. Tchou,Cynthia M. Tracy,Clyde W. Yancy +15 more
TL;DR: The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease.
Journal ArticleDOI
n–3 Fatty Acids in Cardiovascular Disease
TL;DR: This review discusses current knowledge of n–3 fatty acids and suggests that an increased dietary intake of n- fatty acids should be considered as a preventive approach to CVD.
References
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Journal ArticleDOI
Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.
Alan S. Go,Elaine M. Hylek,Kathleen A. Phillips,Yuchiao Chang,Lori E. Henault,Joe V. Selby,Daniel E. Singer +6 more
TL;DR: It is confirmed that atrial fibrillation is common among older adults and provides a contemporary basis for estimates of prevalence in the United States.
Journal ArticleDOI
Atrial Fibrillation Begets Atrial Fibrillation A Study in Awake Chronically Instrumented Goats
TL;DR: Artificial maintenance of AF leads to a marked shortening of AERP, a reversion of its physiological rate adaptation, and an increase in rate, inducibility and stability of AF.
Journal ArticleDOI
Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence
Yoko Miyasaka,Marion E. Barnes,Bernard J. Gersh,Stephen S. Cha,Kent R. Bailey,Walter P. Abhayaratna,James B. Seward,Teresa S.M. Tsang +7 more
TL;DR: The age-adjusted incidence of AF increased significantly in Olmsted County during 1980 to 2000 and the projected number of persons with AF for the United States will exceed 10 million by 2050, underscoring the urgent need for primary prevention strategies against AF development.
Journal ArticleDOI
n−3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases
TL;DR: At sufficiently high intakes, long-chain n-3 polyunsaturated fatty acids (PUFAs), as found in oily fish and fish oils, decrease the production of inflammatory eicosanoids, cytokines, and reactive oxygen species and the expression of adhesion molecules, and are potentially potent antiinflammatory agents.