Abstract 2862: Role of Statins in Prevention of Atrial Fibrillation
Background: Statins are being increasingly recognized as not just lipid lowering agents but also as agents with anti-oxidant properties. They have been reported to decrease the incidence of post-operative atrial fibrillation. Their effect, if any, upon the onset of new atrial fibrillation in patients presenting with an acute coronary syndrome remains unknown.
Methods: This study is part of an ongoing acute coronary syndrome registry. The study population consists of patients admitted to a tertiary care Veterans Administration Hospital with suspicion of an acute coronary syndrome/non-ST-segment elevation MI between November 2001 and January 2006. Clinical information, including whether patients were on a statin or not, was determined by medical record abstraction. All patients had an EKG on admission which was compared to prior EKGs to confirm presence of new-onset atrial fibrillation or flutter. Univariate logistic regression modeling was performed to analyze the relationship between atrial fibrillation/flutter and clinical factors including statin use. Significant variables associated with the presence of atrial fibrillation/flutter were entered into a multivariate regression model.
Results: Out of 1236 patients, 130(10.5%) had new onset atrial fibrillation or flutter and 622(50.3%) were on a statin at the time of admission. Patients with atrial fibrillation were significantly more likely to be older, Caucasian, have signs of congestive heart failure and anemia and much less likely to be on a statin or have chest pain as a presenting complaint. In univariate analysis, patients currently on statins were much less likely to have new onset atrial fibrillation/flutter (OR=0.58, p=0.005, 95%CI=0.40–0.85). This relationship persisted after correcting for age, race, presence of chest pain, signs of congestive heart failure or anemia (OR=0.66, p=0.033, CI=0.45–0.97).
Conclusions: In our study patients presenting with an acute coronary syndrome were much less likely to experience new onset atrial fibrillation/flutter if they were on a statin at the time of presentation. This association needs to be tested further in larger clinical studies to assess if indeed statins are protective against development of atrial fibrillation/flutter.