Humphries Karin H, Lee May, Sheldon Robert, Ramanathan Krishnan, Dorian Paul, Green Martin, Kerr Charles R
Centre for Health Evaluation and Outcomes Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada.
Am Heart J. 2007 Nov;154(5):908-13. doi: 10.1016/j.ahj.2007.07.015. Epub 2007 Sep 6.
Statins have important pleiotropic effects and have been shown to reduce vascular inflammation and the incidence of atrial fibrillation (AF) after cardiac surgery. The role of statins in patients with existing AF is poorly understood. We examined the effect of statins on recurrence of AF in patients after successful cardioversion.
Statin use and documented recurrence of AF after successful cardioversion were evaluated in 625 patients with new onset AF who were followed prospectively in the Canadian Registry of Atrial Fibrillation. Logistic regression was used to model the effect of statin use on the recurrence of AF at 1 year while adjusting for potential confounders including concurrent medications.
In a predominantly male population (62%) with median age 63 years, 12.3% were on statins at baseline. Overall, 32.5% had documented recurrence of AF at 1 year; 23.4% in patients on statins compared to 33.8% in those not on statins (P = .07). After adjustment for baseline differences and concomitant beta-blocker use, statin use was associated with a 74% reduction in AF recurrence, but only in statin users on beta-blockers (OR 0.26, 95% CI 0.10-0.66); statin users not on beta-blockers (OR 1.07, 95% CI 0.44-2.58).
In an observational study of patients with new onset AF, statin use was associated with a significant 74% reduction in the odds of recurrent AF, but only in patients also taking beta-blockers. Importantly, statin without concomitant beta-blocker use was not associated with any changes in AF recurrence.
他汀类药物具有重要的多效性作用，已被证明可减轻心脏手术后的血管炎症和房颤（AF）发生率。他汀类药物在已有房颤患者中的作用尚不清楚。我们研究了他汀类药物对成功复律后房颤复发的影响。
在加拿大房颤登记处对625例新发房颤患者进行前瞻性随访，评估他汀类药物的使用情况以及成功复律后记录的房颤复发情况。采用逻辑回归模型分析他汀类药物使用对1年时房颤复发的影响，并对包括同时使用的药物在内的潜在混杂因素进行校正。
在以男性为主（62%）、中位年龄63岁的人群中，12.3%的患者在基线时服用他汀类药物。总体而言，32.5%的患者在1年时有房颤复发记录；服用他汀类药物的患者为23.4%，未服用他汀类药物的患者为33.8%（P = 0.07）。在对基线差异和同时使用β受体阻滞剂进行校正后，他汀类药物的使用与房颤复发率降低74%相关，但仅在同时使用β受体阻滞剂的他汀类药物使用者中如此（比值比0.26，95%可信区间0.10 - 0.66）；未使用β受体阻滞剂的他汀类药物使用者（比值比1.07，95%可信区间0.44 - 2.58）。
在一项对新发房颤患者的观察性研究中，他汀类药物的使用与房颤复发几率显著降低74%相关，但仅在同时服用β受体阻滞剂的患者中如此。重要的是，未同时使用β受体阻滞剂的他汀类药物与房颤复发的任何变化均无关联。
