Abstract 1424: The Impact of Statins on the Incidence of Atrial Fibrillation in Patients With Coronary Artery Disease
Background: Mounting evidence suggests that statins possess anti-arrhythmic properties and inhibit atrial fibrillation (AF). The goal of this study was evaluate the relationship between statin use and the incidence of AF in a large population-based cohort of patients with coronary artery disease (CAD).
Methods: We identified all Medicare beneficiaries 65 years and older who had been hospitalized for acute myocardial infarction or coronary revascularization between 1995 and 2004 and participated in one of two government-sponsored medication benefit programs. Patients with a history of AF prior to and during hospitalization were excluded. This yielded a cohort of 29,088. The incidence of new AF was compared between patients who were (N=8,450) and were not (N=20,638) prescribed statins within 1 month of hospital discharge following their cardiac event.
Results: New-onset AF within 5 and 10 years was 32.6% and 51.2%, respectively, in patients who received statins, compared to 38.3% and 58.0% in patients who did not receive statins (unadjusted hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.78, 0.86). Multivariable analysis controlling for demographic and clinical confounders indicated that statin use independently reduced the risk of developing new-onset AF compared to non-users (adjusted HR: 0.90; 95%CI: 0.85, 0.94). Adjustment for propensity-score and health-seeking behaviors yielded nearly identical results.
Conclusions: Statin therapy initiated within 1 month after hospital discharge is independently associated with a reduction in the risk of new-onset AF after myocardial infarction or coronary revascularization. These findings lend support to the anti-arrhythmic effects of statins and suggest another benefit for their use in patients with CAD.