ArticleJournal of the American Heart Association2025
Mineralocorticoid Receptor Antagonism Reduces Atrial Arrhythmias Post-Cardiac Surgery and Attenuates Atrial Stress Responses to Cardioplegic Arrest.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- A 2025 Literature Review on Arrhythmias: Returning the Focus to Basic Science.The Journal of innovations in cardiac rhythm management · 2026Article
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19 authors.
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Abstract
backgroundPostoperative atrial fibrillation occurs in ~40% after cardiac surgery. Mineralocorticoid receptor antagonists (MRA) are known to reduce chronic atrial fibrillation (AF) development and burden. We evaluated the association of preoperative MRA use with postoperative atrial fibrillation and investigated atrial cell types modulated by MRAs during cold preservation.
methodsWe studied 19 042 cardiac surgery patients at Mayo Clinic. Propensity 1:3 matching identified 298 MRA users and 894 non-users. A subgroup analysis of patients on any preoperative diuretic was performed to isolate cardiac-specific effects of MRAs, matching 298 MRA users to 894 non-MRA diuretic users. AF recurrence was assessed for up to 6-years. Single-nucleus RNA sequencing (snRNA-seq) was performed on human donor atria exposed to canrenone (a water-soluble MRA) during cold preservation with ex-vivo reperfusion, and expression profiles were compared with atria from patients with AF.
resultsAfter matching, preoperative MRA use was associated with a lower incidence of postoperative atrial fibrillation (19.8% versus 31.8%,
conclusionsPreoperative MRAs were associated with reduced postoperative and long-term AF after cardiac surgery. Mechanistically, our ex-vivo human atrial model revealed that MRAs suppress mineralocorticoid receptor -driven atrial stress responses, particularly in conduction-relevant cardiomyocytes.
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