Cardiology Department, Hoˆpital Europe´en Georges Pompidou and Universite´ Paris Descartes, Paris, France.
Heart. 2010 Nov;96(22):1809-14. doi: 10.1136/hrt.2010.201574.
Atrial fibrillation developing at the acute stage of myocardial infarction is associated with untoward clinical outcomes. The aim of this study was to determine correlations between early statin therapy and atrial fibrillation in acute myocardial infarction.
Patients (3396) with sinus rhythm developing acute myocardial infarction were enrolled in the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI).
Atrial fibrillation developed in 7.0% of patients without and 3.9% of patients with early (≤48 h of admission) statin therapy (p<0.001). Multivariable analysis, including the propensity score for early statin treatment, showed that statin therapy was associated with reduced risk of atrial fibrillation (OR 0.64; 95% CI 0.45 to 0.92, p=0.017). Compared to patients without early statin therapy, the OR for atrial fibrillation were 0.72 (0.49 to 1.04, p=0.080), 0.52 (0.28 to 0.95, p=0.034) and 0.40 (0.18 to 0.92, p=0.030) in patients on conventional, intermediate and high doses respectively.
This study is the first to document a correlation between early statin therapy and atrial fibrillation at the early stage of acute myocardial infarction.
心肌梗死后急性阶段发生的心房颤动与不良临床结局相关。本研究旨在确定急性心肌梗死后早期他汀类药物治疗与心房颤动之间的相关性。
本研究纳入了窦性心律的急性心肌梗死患者（3396 例），这些患者来自法国急性 ST 段抬高和非 ST 段抬高型心肌梗死登记研究（FAST-MI）。
在未接受早期（≤48 小时）他汀类药物治疗的患者中，心房颤动的发生率为 7.0%，而在接受早期他汀类药物治疗的患者中，发生率为 3.9%（p<0.001）。多变量分析包括早期他汀类药物治疗的倾向评分，结果表明他汀类药物治疗与心房颤动风险降低相关（OR 0.64；95%CI 0.45 至 0.92，p=0.017）。与未接受早期他汀类药物治疗的患者相比，早期接受常规、中剂量和高剂量他汀类药物治疗的患者发生心房颤动的 OR 分别为 0.72（0.49 至 1.04，p=0.080）、0.52（0.28 至 0.95，p=0.034）和 0.40（0.18 至 0.92，p=0.030）。
本研究首次记录了急性心肌梗死后早期他汀类药物治疗与心房颤动之间的相关性。
