title: The role of statin therapy in the prevention of atrial fibrillation: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia, and AF is associated with relatively higher all-cause mortality in both men and women. However, there are limited treatment options for AF. Statins are hypothesized to have a benefit against arrhythmias in addition to well-established secondary prevention benefit for atherosclerotic coronary artery disease, yet the data are inconsistent
  
  
  CONCLUSIONS
  Statin therapy was significantly associated with a decreased risk of incidence or recurrence of AF. The benefit of statin therapy seemed more markedly in secondary prevention than primary prevention. These results provided some evidence for the benefit of statins beyond their lipid-lowering activity
  
  
  OBJECTIVE
  The use of statins has been suggested to protect against atrial fibrillation (AF) in some clinical observational and experimental studies but has remained inadequately explored. This study was designed to examine whether statins can reduce the risk of AF.
  
  
  METHODS
  Meta-analysis of randomized, controlled trials with use of statins on incidence or recurrence of AF was performed.
  
  
  RESULTS
  Twenty studies with 23,577 patients were included in the analysis. Seven studies investigated the use of statins in patients with AF, 11 studies investigated the primary prevention of statins in patients without AF, and two studies investigated mixed populations of patients. The incidence or recurrence of AF occurred in 1543 patients. Overall, statin therapy was significantly associated with a decreased risk of AF compared with control (odds ratio 0.49, 95% confidence interval 0.37-0.65; P < 0.00001). A beneficial effect was found in the atorvastatin subgroup and the simvastatin subgroup, but not in the pravastatin subgroup or the rosuvastatin subgroup. The benefit of statin therapy appeared to be more pronounced in secondary prevention (odds ratio 0.34, 95% confidence interval 0.18-0.64; P < 0.0008) than in primary prevention (odds ratio 0.54, 95% confidence interval 0.40-0.74; P < 0.0001).
  
  
  CONCLUSIONS
  Statin therapy was significantly associated with a decreased risk of incidence or recurrence of AF. Heterogeneity was explained by differences in statin types, patient populations and surgery types. The benefit of statin therapy seemed more pronounced in secondary than in primary prevention.
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China. fwtfu@163.com
authors.forename: Wen-tong
authors.initials: WT
authors.lastname: Fang
authors.forename: Hong-Jian
authors.initials: HJ
authors.lastname: Li
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
authors.forename: Su
authors.initials: S
authors.lastname: Jiang
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D011322:Primary Prevention / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D055502:Secondary Prevention / Q000379:methods
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors