Effects of cilazapril on endothelial cell function and fibrinolysis system in atrial fibrillation

Recently, it has been found that atrial fibrillation (AF) is associated with renin angiotensin aldosterone system (RAAS) activation and that angiotensin converting enzyme inhibition (ACEI) reduces incidence of AF in hypertensive patients. The relationship between ACEI and atrial remodelling in AF has been studied widely, but little is known about the mechanisms linking ACEI to thrombus formation in AF. Studies have shown that ACEI treatment can favourably influence endothelial dysfunction in hypertensive and heart failure patients and potentially modulate the fibrinolytic system in cardiopulmonary bypass patients. These data suggest that ACEI might influence the hypercoagulable state in AF. The objective of this study was to evaluate whether cilazapril, an ACEI, was conducive to hypercoagulated state in AF.