The relationship between statin use and atrial fibrillation.
OBJECTIVE
To investigate the relationship between statin therapy and the development of new-onset, recurrent, and postoperative atrial fibrillation (AF).


METHODS
A systematic literature search was conducted through September 2006. Included studies were either randomized, controlled trials or observational studies with adjusted analyses using multivariate regression or covariate matching, compared patients receiving or not receiving a statin, and reported data on the incidence of AF. Weighted averages were reported as odds ratios with 95% confidence intervals (CIs) using a random-effects model.


METHODS
The primary outcome measured was a combined endpoint of any AF type. Secondary outcomes included new-onset, recurrent, and postoperative AF.


RESULTS
Fourteen trials reporting the results of 15 unique analyses (n = 7402) were included. There was a 20% incidence rate for any AF with varying rates depending on AF type (new-onset [11%], recurrent [56%], recurrent after cardioversion [54%], postoperative [22%]). The use of a statin reduced the odds of developing any AF by 45% (odds ratio [OR] 0.55; 95% CI 0.43-0.70); Q statistic p = 0.001). Statins reduced the odds of developing new-onset AF by 32% (OR 0.68; 95% CI 0.51-0.90), recurrent AF by 57% (OR 0.43; 95% CI 0.24-0.79), recurrent AF after cardioversion by 42% (OR 0.58; 95% CI 0.32-1.05) and postoperative AF by 58% (OR 0.42; 95% CI 0.27-0.65).


CONCLUSIONS
We considered studies that were observational in nature or only available in abstract form. Publication bias could not be ruled out.


CONCLUSIONS
Statin therapy was associated with a reduced odds of developing AF, thus providing evidence of the benefit of statins beyond the lipid-lowering activity.
Patel
Aarti A
AA
University of Connecticut School of Pharmacy, Storrs, CT, USA.
White
C Michael
CM
Shah
Sachin A
SA
Dale
Krista M
KM
Kluger
Jeffrey
J
Coleman
Craig I
CI
D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007249:Inflammation / Q000188:drug therapy*; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors