Naji Franjo, Suran David, Kanic Vojko, Vokac Damijan, Sabovic Miso
Department of Cardiology and Angiology, University Clinical Centre, Maribor, Slovenia.
Med Sci Monit. 2009 Sep;15(9):CR494-8.
Amiodarone is effective in preventing atrial fibrillation (AF). Recently, the possible antiarrhythmic effects of statins have been revealed. We hypothesized that statins added to amiodarone may reduce the recurrence rate of AF after successful electrical cardioversion (EC).
MATERIAL/METHODS: The retrospective analysis included 198 consecutive patients (63+/-10 years; 56% men) with persistent AF (lasting at least one month, average 5.8+/-7.6 months) who underwent successful EC. All patients were put on long-time treatment with amiodarone according to standard protocol prior to EC; 50 patients (25%) also received statin therapy. AF recurrence was recorded in the following two years.
Recurrence of AF occurred less frequently in patients receiving statins and amiodarone than in those receiving amiodarone only (24 (48.0%) vs. 95 (64.1%) patients). The mean AF-free period was significantly prolonged in the statin-amiodarone group (513+/-38 days vs. 374+/-25 days, log rank test P<0.02). Cox univariate analysis showed that treatment with statins and the duration of AF before EC were significant predictors for AF recurrence. After adjustment for other potential confounders, statin therapy proved to be a statistically significant predictor of sinus rhythm maintenance (adjusted OR 0.60, 95% CI 0.38 to 0.93, P=0.02).
Our study shows that adding statins to amiodarone significantly decreases the recurrence rate of AF after successful EC in patients with persistent AF. Our findings urge for prospective randomized studies to be performed in order to confirm these results and elucidate the role of statins in AF prevention.
胺碘酮在预防心房颤动（房颤）方面有效。最近，他汀类药物的潜在抗心律失常作用已被揭示。我们假设，在胺碘酮基础上加用他汀类药物可能会降低成功电复律（EC）后房颤的复发率。
材料/方法：回顾性分析纳入了198例连续的持续性房颤患者（年龄63±10岁；56%为男性），这些患者成功接受了电复律，房颤持续至少1个月（平均5.8±7.6个月）。所有患者在电复律前均按照标准方案接受胺碘酮长期治疗；50例患者（25%）还接受了他汀类药物治疗。记录接下来两年内房颤的复发情况。
接受他汀类药物和胺碘酮治疗的患者房颤复发频率低于仅接受胺碘酮治疗的患者（分别为24例（48.0%）和95例（64.1%））。他汀类药物联合胺碘酮组的无房颤平均时间显著延长（513±38天 vs. 374±25天，对数秩检验P<0.02）。Cox单因素分析显示，他汀类药物治疗以及电复律前房颤持续时间是房颤复发的重要预测因素。在对其他潜在混杂因素进行校正后，他汀类药物治疗被证明是窦性心律维持的统计学显著预测因素（校正后的比值比为0.60，95%置信区间为0.38至0.93，P=0.02）。
我们的研究表明，在持续性房颤患者成功电复律后，在胺碘酮基础上加用他汀类药物可显著降低房颤复发率。我们的研究结果促使开展前瞻性随机研究，以证实这些结果并阐明他汀类药物在预防房颤中的作用。
