Abstract 2864: Antiarrhythmic Effect of Statins and Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials.
The use of statins has been suggested to protect against atrial fibrillation (AF) in some clinical and experimental studies but remained inadequately explored. Specifically, observational studies provided evidence supporting a protective role of statins against atrial fibrillation. However, insufficient data are available at this time to allow recommendations for prevention of AF using statins. In order to improve the evaluation of their possible benefit, we performed a metaanalysis of randomized trials with statins on the endpoint of incidence or recurrence of atrial fibrillation.
Methods. A systematic review of controlled trials with statins was performed. Data sources included Medline, Embase, Cochrane central register of controlled trials, and hand search. Predefined criteria were used to select controlled clinical trials. Eligible studies had to be randomized, controlled, parallel-design human trials with use of statins that collected data on incidence or recurrence of atrial fibrillation. Data were extracted for patients’ characteristics, interventions, quality of trials, and rates of events.
Results. Four studies with 430 patients in sinus rhythm were included in the analysis. Three studies investigated the use of statins in patients with a history of paroxysmal AF (n = 1) or persistent AF after electrical cardioversion (n = 2) and one in primary prevention of AF in patients undergoing cardiac surgery. Coronary artery disease was present in 179/430 patients (42 %). Beta blockers were prescribed in 243/430 (57 %) and amiodarone in 7/430 (1.6 %) of the patients. Incidence or recurrence of atrial fibrillation occurred in 190 patients: 70/216 in patients treated with statin vs 120/214 in controls. Thus, the use of statins was significantly associated with a decreased risk of atrial fibrillation compared to control (relative risk 0.37, 95% confidence interval 0.25 to 0.55, p < 0.0001).
Conclusions. In randomized trials, use of statins in patients in sinus rhythm with a history of previous AF or undergoing cardiac surgery was significantly associated with a decreased risk of incidence or recurrence of atrial fibrillation.