Ozaydin Mehmet, Varol Ercan, Aslan Suleyman M, Kucuktepe Zehra, Dogan Abdullah, Ozturk Mustafa, Altinbas Ahmet
Department of Cardiology, Suleyman Demirel University Medical School, Isparta, Turkey.
Am J Cardiol. 2006 May 15;97(10):1490-3. doi: 10.1016/j.amjcard.2005.11.082. Epub 2006 Mar 29.
To study the effect of atorvastatin on recurrence of atrial fibrillation (AF) after electrical cardioversion (EC), 48 patients with AF lasting 48 hours who were scheduled for EC were randomized to the atorvastatin (group I) and control (group II) groups. Six patients in group I (25%) and 2 patients in group II (8.3%) had spontaneous conversion before EC (p >0.05). The end point was the recurrence of AF during 3 months of follow-up. Eighteen patients in group I (12.5%) and 11 patients in group II (45.8%) had recurrence (p = 0.01, log-rank test). With the Cox proportional model, the predictors of recurrence included a body mass index of 25 to 30 kg/m2 (relative risk [RR] 0.07, 95% confidence interval [CI] 0.008 to 0.59), body mass index > or = 30 kg/m2 (RR 0.24, 95% CI 0.08 to 0.72), AF duration of > or = 3 months (RR 0.28, 95% CI 0.09 to 0.83), diabetes mellitus (RR 0.34, 95% CI 0.12 to 0.98), and left atrial diameter of > or = 45 mm (RR 0.23, 95% CI 0.07 to 0.74). Atorvastatin was associated with a significantly reduced risk of developing AF (unadjusted RR 0.23, 95% CI 0.064 to 0.82, p = 0.024). This association remained significant after adjustment for these predictors (adjusted RR 0.19, 95% CI 0.052 to 0.72, p = 0.01). High-sensitivity C-reactive protein levels at baseline were not different between the 2 groups (p = 0.92). Although the high-sensitivity C-reactive protein levels decreased significantly 48 hours after EC compared with the baseline levels in group I (2.82 +/- 1.46 vs 2.56 +/- 1.3 mg/dl, p = 0.02), no significant change occurred in group II (2.87 +/- 0.8 vs 2.84 +/- 0.8 mg/dl, p = 0.09). In conclusion, atorvastatin decreased the recurrence rate of AF after EC.
为研究阿托伐他汀对电复律（EC）后房颤（AF）复发的影响，将48例持续时间达48小时且计划接受EC的AF患者随机分为阿托伐他汀组（I组）和对照组（II组）。I组6例患者（25%）和II组2例患者（8.3%）在EC前发生了自发复律（p>0.05）。终点为随访3个月期间AF的复发情况。I组18例患者（12.5%）和II组11例患者（45.8%）出现复发（p = 0.01，对数秩检验）。采用Cox比例模型，复发的预测因素包括体重指数为25至30 kg/m2（相对危险度[RR] 0.07，95%置信区间[CI] 0.008至0.59）、体重指数≥30 kg/m2（RR 0.24，95% CI 0.08至0.72）、AF持续时间≥3个月（RR 0.28，95% CI 0.09至0.83）、糖尿病（RR 0.34，95% CI 0.12至0.98）以及左心房直径≥45 mm（RR 0.23，95% CI 0.07至0.74）。阿托伐他汀与AF发生风险显著降低相关（未校正RR 0.23，95% CI 0.064至0.82，p = 0.024）。在对这些预测因素进行校正后，这种相关性仍然显著（校正RR 0.19，95% CI 0.052至0.72，p = 0.01）。两组基线时的高敏C反应蛋白水平无差异（p = 0.92）。尽管与I组基线水平相比，EC后48小时高敏C反应蛋白水平显著降低（2.82±1.46 vs 2.56±1.3 mg/dl，p = 0.02），但II组未发生显著变化（2.87±0.8 vs 2.84±0.8 mg/dl，p = 0.09）。总之，阿托伐他汀降低了EC后AF的复发率。
