Department of Pharmacy, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Br J Clin Pharmacol. 2012 Nov;74(5):744-56. doi: 10.1111/j.1365-2125.2012.04258.x.
Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia, and AF is associated with relatively higher all-cause mortality in both men and women. However, there are limited treatment options for AF. Statins are hypothesized to have a benefit against arrhythmias in addition to well-established secondary prevention benefit for atherosclerotic coronary artery disease, yet the data are inconsistent
Statin therapy was significantly associated with a decreased risk of incidence or recurrence of AF. The benefit of statin therapy seemed more markedly in secondary prevention than primary prevention. These results provided some evidence for the benefit of statins beyond their lipid-lowering activity
The use of statins has been suggested to protect against atrial fibrillation (AF) in some clinical observational and experimental studies but has remained inadequately explored. This study was designed to examine whether statins can reduce the risk of AF.
Meta-analysis of randomized, controlled trials with use of statins on incidence or recurrence of AF was performed.
Twenty studies with 23,577 patients were included in the analysis. Seven studies investigated the use of statins in patients with AF, 11 studies investigated the primary prevention of statins in patients without AF, and two studies investigated mixed populations of patients. The incidence or recurrence of AF occurred in 1543 patients. Overall, statin therapy was significantly associated with a decreased risk of AF compared with control (odds ratio 0.49, 95% confidence interval 0.37-0.65; P < 0.00001). A beneficial effect was found in the atorvastatin subgroup and the simvastatin subgroup, but not in the pravastatin subgroup or the rosuvastatin subgroup. The benefit of statin therapy appeared to be more pronounced in secondary prevention (odds ratio 0.34, 95% confidence interval 0.18-0.64; P < 0.0008) than in primary prevention (odds ratio 0.54, 95% confidence interval 0.40-0.74; P < 0.0001).
Statin therapy was significantly associated with a decreased risk of incidence or recurrence of AF. Heterogeneity was explained by differences in statin types, patient populations and surgery types. The benefit of statin therapy seemed more pronounced in secondary than in primary prevention.
心房颤动（AF）是最常见的具有临床意义的心律失常，AF 与男性和女性的全因死亡率升高相关。然而，AF 的治疗选择有限。他汀类药物除了对动脉粥样硬化性冠状动脉疾病具有明确的二级预防作用外，还有助于预防心律失常，这一假说已得到验证，但数据并不一致。
他汀类药物治疗与 AF 的发生率或复发风险降低显著相关。他汀类药物治疗的获益在二级预防中比一级预防中更为明显。这些结果为他汀类药物除了降脂作用之外的益处提供了一些证据。
一些临床观察性和实验性研究表明，他汀类药物的使用可以预防心房颤动（AF），但尚未得到充分探索。本研究旨在检验他汀类药物是否可以降低 AF 的风险。
对使用他汀类药物预防 AF 发生率或复发的随机对照试验进行荟萃分析。
分析纳入了 20 项研究共 23577 例患者。其中 7 项研究评估了 AF 患者中使用他汀类药物的情况，11 项研究评估了他汀类药物在无 AF 患者中的一级预防作用，2 项研究评估了混合人群。AF 的发生率或复发发生在 1543 例患者中。总体而言，与对照组相比，他汀类药物治疗与 AF 风险降低显著相关（比值比 0.49，95%置信区间 0.37-0.65；P<0.00001）。阿托伐他汀亚组和辛伐他汀亚组中发现了有益作用，但普伐他汀亚组和罗苏伐他汀亚组中未发现有益作用。他汀类药物治疗的获益在二级预防中似乎更为明显（比值比 0.34，95%置信区间 0.18-0.64；P<0.0008），而在一级预防中则不明显（比值比 0.54，95%置信区间 0.40-0.74；P<0.0001）。
他汀类药物治疗与 AF 的发生率或复发风险降低显著相关。异质性可通过他汀类药物类型、患者人群和手术类型的差异来解释。他汀类药物治疗的获益在二级预防中比一级预防中更为明显。
