Statins Found to Reduce Risk of Recurrent Atrial Fibrillation

TOURS, France, Feb. 18 -- Statin therapy significantly reduces the risk of atrial fibrillation in patients with a history of the condition and other high-risk groups, a meta-analysis has suggested.

Overall, statins reduced the odds ratio for atrial fibrillation by more than 60% compared with patients who did not receive the drugs, Laurent Fauchier, M.D., Ph.D., of Trousseau University Hospital Center, and colleagues reported in the Feb. 26 issue of the Journal of the American College of Cardiology.

Statins appeared to exert a greater impact in secondary prevention of atrial fibrillation rather than new-onset or postoperative atrial fibrillation.

"These results provide some evidence of the benefit of statins beyond their lipid-lowering activity," the authors concluded. "However, large-scale, prospective, randomized clinical trials are still needed to establish whether statins bring a similar benefit and are an appropriate therapeutic option in all subgroups of patients for the management of atrial fibrillation."

Observational studies have provided evidence of a protective effect of statins against atrial fibrillation. However, data were insufficient to provide a basis for recommending statin therapy to prevent the arrhythmia.

In an attempt to bring the potential atrial fibrillation benefit into sharper focus, Dr. Fauchier and colleagues searched for all randomized controlled trials of statins published from January 1980 through June 2007. They identified six trials involving 3,557 patients given statins versus placebo or a control therapy for treatment or prevention of atrial fibrillation.

Three studies examined the use of statins in patients with a history of paroxysmal atrial fibrillation or who were undergoing cardioversion for persistent atrial fibrillation. The remaining three trials evaluated statins in patients undergoing cardiac surgery or after acute coronary syndrome.

Overall, statin therapy was associated with a 61% decrease in the risk of atrial fibrillation (OR 0.39, 95% CI 0.18 to 0.85, P=0.02). Separate analyses suggested a more marked effect in the setting of secondary prevention (OR 0.33, 95% CI 0.10 to 1.03, P=0.06) than for new-onset or postoperative atrial fibrillation (OR 0.60, 95% CI 0.27 to 1.37, P=0.23).

The authors acknowledged they were unable to evaluate the possible impact of statin dose or the degree of LDL-lowering on arrhythmic events. They also noted that atrial fibrillation might arise from different factors in different patient subgroups, potentially making certain patients more responsive to an intervention compared with others.

Despite those limitations, Dr. Fauchier and colleagues concluded, "Use of statins was significantly associated with a decreased risk of incidence or recurrence of AF inpatients in sinus rhythm with a history of previous AF or undergoing cardiac surgery or after acute coronary syndrome."

The authors reported no disclosures.

Primary source: Journal of the American College of CardiologySource reference:Fauchier L, et al "Antiarrhythmic effect of statin therapy and atrial fibrillation: a meta-analysis of randomized controlled trials" J Am Coll Cardiol 2008; 51: DOI:10.1016/j.jacc.2007.09.063.