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瑞舒伐他汀对心房颤动发生的影响:GISSI-HF 试验的辅助结果。

Effects of rosuvastatin on atrial fibrillation occurrence: ancillary results of the GISSI-HF trial.

机构信息

GISSI-HF Coordinating Center, ANMCO Research Center, Via La Marmora, 34, 50121 Florence, Italy.

出版信息

Eur Heart J. 2009 Oct;30(19):2327-36. doi: 10.1093/eurheartj/ehp357. Epub 2009 Aug 30.

Abstract

AIMS

This ancillary analysis of the GISSI-HF database aims at assessing the effect of rosuvastatin on the occurrence of atrial fibrillation (AF) in patients with chronic heart failure (HF) who were not in AF at study entry.

METHODS AND RESULTS

GISSI-HF was a double-blind, placebo-controlled trial testing n-3 PUFA and rosuvastatin vs. corresponding placebos in patients with chronic HF. Atrial fibrillation occurrence was defined as the presence of AF in the electrocardiogram (ECG) performed at each visit during the trial or AF as a cause of worsening HF or hospital admission or as an event during hospitalization. Among the 3690 patients (80.7%) without AF on their baseline ECG, 15.0% developed AF during a median follow-up period of 3.7 years, 258 randomized to rosuvastatin (13.9%) vs. 294 allocated to placebo (16.0%). Although the difference was not significant at unadjusted analysis (P = 0.097) and multivariable analysis adjusting for clinical variables (P = 0.067), it became significant after adjustment for clinical variables and laboratory examinations (P = 0.039), and for clinical variables, laboratory examinations, and background therapies (P = 0.038).

CONCLUSION

This study shows that there is some evidence of a beneficial effect of rosuvastatin in terms of reduction of AF occurrence in patients with HF. Larger populations are needed to provide a definite answer to the question. ClinicalTrials.gov Identifier: NCT00336336.

摘要

目的

本 GISSI-HF 数据库的辅助分析旨在评估瑞舒伐他汀对研究入组时无房颤(AF)的慢性心力衰竭(HF)患者发生房颤的影响。

方法和结果

GISSI-HF 是一项双盲、安慰剂对照试验,旨在测试 n-3PUFA 和瑞舒伐他汀与相应安慰剂在慢性 HF 患者中的疗效。房颤的发生定义为在试验期间每次就诊时心电图(ECG)中存在 AF 或 AF 为 HF 恶化、住院或住院期间事件的原因。在 3690 名基线 ECG 无 AF 的患者中(80.7%),中位数随访 3.7 年期间有 15.0%发生了 AF,其中 258 名随机分配至瑞舒伐他汀(13.9%),294 名分配至安慰剂(16.0%)。虽然未经调整分析差异无统计学意义(P=0.097),且多变量分析调整临床变量后差异也无统计学意义(P=0.067),但调整临床变量和实验室检查后差异具有统计学意义(P=0.039),进一步调整临床变量、实验室检查和背景治疗后差异仍具有统计学意义(P=0.038)。

结论

本研究表明,瑞舒伐他汀在降低 HF 患者房颤发生率方面具有一定的获益证据。需要更大的人群来为这个问题提供明确的答案。临床试验注册号:NCT00336336。

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