title: Association between statin therapy and reductions in atrial fibrillation or flutter and inappropriate shock therapy.
abstract: OBJECTIVE
  In patients without implantable cardioverter defibrillators (ICDs), statins have been shown to reduce the incidence of atrial fibrillation and atrial flutter (AF/AFL). We sought to determine if statin therapy could reduce the occurrence of AF/AFL with rapid ventricular rates with and without inappropriate shock therapy among a large heterogeneous ICD cohort.
  
  
  RESULTS
  We prospectively followed 1445 consecutive patients receiving an ICD for the primary (n = 833) or secondary (n = 612) prevention from December 1997 through January 2007. Outcome measures include incidence of AF/AFL that initiated ICD therapy or was detected during ICD interrogation. Cox hazard regression analyses were conducted to determine the predictors of AF/AFL with and without inappropriate shock delivery and did not include inappropriate shocks resulting from lead dysfunction or other exogenous factors. Patients in this study (n = 1445) were followed over a mean follow-up period of (mean +/- SD) 874 +/- 805 days. There were 563 episodes of AF/AFL detected, with 200 episodes resulting in inappropriate shock therapy. Overall, 745 patients received statin therapy and 700 did not. The use of statin therapy was associated with an adjusted hazard ratio of 0.472 [95% confidence interval (CI), 0.349-0.638, P < 0.001] for the development of AF/AFL with shock therapy and 0.613 (95% CI, 0.496-0.758, P < 0.001) without shock therapy when compared with the group without statin use.
  
  
  CONCLUSIONS
  Among a cohort with ICDs at high risk for cardiac arrhythmias, statin therapy was associated with a reduction in AF/AFL tachyarrhythmia detection and inappropriate shock therapy.
authors.affiliation: Division of Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102-5037, USA.
authors.forename: Sanjeev P
authors.initials: SP
authors.lastname: Bhavnani
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
authors.forename: Charles M
authors.initials: CM
authors.lastname: White
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Clyne
authors.forename: Ravi
authors.initials: R
authors.lastname: Yarlagadda
authors.forename: Danette
authors.initials: D
authors.lastname: Guertin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kluger
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D001282:Atrial Flutter / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D015331:Cohort Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors