Abstract 10443: Statins Reduce New-Onset Atrial Fibrillation in Patients with First Time Myocardial Infarction and Show Dose and Type Dependent Effect - A National Cohort Study.
Objective: Statins have been reported as an upstream therapy to prevent atrial fibrillation (AF) due to pleiotropic effects, but previous studies have reported conflicting results in primarily small populations. The objective of this study was to evaluate the effect of statins in relation to type and dosage to prevent new-onset AF in a nationwide cohort of first-time myocardial infarction (MI) patients.
Methods: All patients with first-MI 1997-2009 in Denmark and their prescription claims for statins within 3 months after discharge were identified by individual-level-linkage of nationwide registers of hospitalization and drug dispensing from pharmacies. During this period statins gradually became standard treatment after MI. Patients with previous history of AF were excluded. The effect of statins on occurrence of new-onset AF were analyzed in multivariable time-dependent Cox regressions models adjusted for age, gender, year, concomitant medication and comorbidity, and additionally in propensity score matched analysis. Furthermore, the effect of different dose and type of statin on new-onset AF was examined.
Results: A total of 89,703 patients were included in this study; 56,044 patients received statin treatment after discharge. New-onset AF was registered in 5698 (10%) and 5010 (15%) patients receiving and not receiving statin treatment, respectively. The adjusted Cox regression analysis showed significant reduction in new-onset AF (HR:0.84 [95%CI: 0.80-0.88], p<0.001) in statin users. Furthermore, there was a dose and type dependent effect of statins on new-onset AF (Figure). Pravastatin, the least potent lipid lowering statin, showed no effect, whereas high dose Atorvastatin showed the best effect on new-onset AF.
Conclusions: Statin therapy significantly reduces new-onset AF in a nationwide cohort of post-MI patients. Furthermore statin therapy showed a type and dose-dependent effect on new-onset AF.
- © 2011 by American Heart Association, Inc.