Comparison of atorvastatin and simvastatin in prevention of atrial fibrillation after successful cardioversion.
Recent data have shown that statins can help prevent atrial fibrillation (AF). We hypothesized that statins vary in their ability to prevent AF after successful electrical cardioversion (EC).Sixty-five patients (29 receiving atorvastatin and 36 receiving simvastatin) who had undergone successful EC for persistent AF were included in the study. They received statins at least one month before EC, and continued the treatment through 2 years of follow-up. The statins they received were selected independently by their attending physicians. In the follow-up period, AF reoccurred in 11 (38.0%) patients of the atorvastatin group and in 24 (66.7%) patients of the simvastatin group. Using a logistic regression model, the unadjusted odds ratio (OR) of having an AF recurrence for patients on atorvastatin versus those on simvastatin was 0.31 (95% CI 0.11-0.85, P = 0.02). After adjustment for other potentially confounding variables (age, sex, hypertension, diabetes, ischemic heart disease, echocardiographic characteristics, and therapy), treatment with atorvastatin retained its significance for maintaining sinus rhythm in a multivariate model (OR 0.20, CI 0.04 to 0.98, P < 0.05).Our study suggests that atorvastatin and simvastatin exert different effects on the AF recurrence rate after successful EC. Larger prospective randomized trials are needed to definitively evaluate the role of different statins in patients with AF, especially on AF recurrence after EC.
Department of Cardiology and Angiology, University Clinical Centre Maribor, Slovenia.
Franjo
F
Naji
David
D
Suran
Vojko
V
Kanic
Damijan
D
Vokac
Miso
M
Sabovic
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control* / Q000628:therapy; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D019821:Simvastatin / Q000627:therapeutic use*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin