Xia Wei, Yin Zuomin, Li Jingjie, Song Ying, Qu Xiufen
Department of Cardiology, First Affiliated Hospital, Harbin Medical University, Heilongjiang, China.
Pacing Clin Electrophysiol. 2009 Dec;32(12):1562-6. doi: 10.1111/j.1540-8159.2009.02554.x. Epub 2009 Sep 30.
High levels of asymmetric dimethylarginine (ADMA) are associated with an increased risk of early recurrence of atrial fibrillation (AF) after electrical cardioversion. We aimed to investigate the effects of rosuvastatin on serum ADMA levels and early recurrence of AF following successful electrical cardioversion.
A total of 64 patients with persistent AF, but without known heart disease, who underwent elective electrical cardioversion were randomized to the rosuvastatin (group I, n = 32) and control (group II, n = 32) groups. The end point was the recurrence of AF during the 3 months of follow-up.
The baseline ADMA levels were not different between the two groups. At the end of follow-up, serum ADMA levels in group I decreased compared with the baseline levels, whereas no significant change occurred in group II. During the follow-up, five patients in group I (15.6%) and 13 in group II (40.6%) had AF recurrence (P < 0.05, log-rank test). With the Cox proportional model, the predictors of recurrence included age > or =65 years, left atrial diameter >45 mm, and baseline ADMA levels > or =2.0 micromol/l. Rosuvastatin was associated with a reduced risk of AF recurrence (relative risk 0.35, 95% confidence interval 0.12-0.96, P < 0.05).
Rosuvastatin decreased the early recurrence of AF following successful electrical cardioversion with reduced ADMA levels.
高水平的不对称二甲基精氨酸（ADMA）与电复律后房颤（AF）早期复发风险增加相关。我们旨在研究瑞舒伐他汀对成功电复律后血清ADMA水平及AF早期复发的影响。
共有64例持续性AF但无已知心脏病的患者接受了择期电复律，将其随机分为瑞舒伐他汀组（I组，n = 32）和对照组（II组，n = 32）。终点为随访3个月期间AF的复发情况。
两组的基线ADMA水平无差异。随访结束时，I组血清ADMA水平较基线水平降低，而II组无显著变化。随访期间，I组有5例患者（15.6%）发生AF复发，II组有13例患者（40.6%）发生AF复发（P < 0.05，对数秩检验）。采用Cox比例模型，复发的预测因素包括年龄≥65岁、左心房直径>45 mm以及基线ADMA水平≥2.0 μmol/L。瑞舒伐他汀与AF复发风险降低相关（相对风险0.35，95%置信区间0.12 - 0.96，P < 0.05）。
瑞舒伐他汀降低了成功电复律后AF的早期复发率，并降低了ADMA水平。
