Department of Cardiology, Children's Hospital of Chongqing Medical University, Chongqing, P. R. China.
Int J Med Sci. 2013;10(2):198-205. doi: 10.7150/ijms.5248. Epub 2013 Jan 10.
It is a controversy whether statins therapy could be beneficial for the occurrence of atrial fibrillation (AF) in acute coronary syndrome (ACS). To clarify this problem, we performed a meta-analysis with the currently published literatures.
The electronic databases were searched to obtain relevant trials which met the inclusion criteria through October 2011. Two authors independently read the trials and extracted the related information from the included studies. Either fixed-effects models or random-effects models were assumed to calculate the overall combined risk estimates according to I(2 )statistic. Sensitivity analysis was conducted by omitting one study in each turn, and publication bias was evaluated using Begg's and Egger's test.
Six studies were eligible to inclusion criteria, of the six studies, 161305 patients were included in this meta-analysis, 77920 (48.31%) patients had taken the statins therapy, 83385 (51.69%) patients had taken non-statins therapy. Four studies had investigated the effect of statins therapy on occurrence of new-onset AF in ACS patients, another two had described the association between statins therapy and occurrence of AF in ACS patients with AF in baseline. The occurrence of AF was reduced 35% in statins therapy group compared to that in non-statins group (95% confident interval: 0.55-0.77, P<0.0001), and the effect of statins therapy seemed more beneficial for new-onset AF (RR=0.59, 95%CI: 0.48-0.73, p=0.096) than secondary prevention of AF (RR=0.70, 95%CI: 0.43-1.14, p=0.085). There was no publication bias according to the Begg's and Egger's test (Begg, p=0.71; Egger, p=0.73).
Statins therapy could reduce the risk of atrial fibrillation in patients with ACS.
他汀类药物治疗是否对急性冠脉综合征（ACS）患者的心房颤动（AF）发生有益，这存在争议。为阐明这一问题，我们对已发表的文献进行了荟萃分析。
通过电子数据库检索，获取符合纳入标准的相关试验，检索时间截止至 2011 年 10 月。由两名作者独立阅读试验并从纳入研究中提取相关信息。根据 I(2)统计量，采用固定效应模型或随机效应模型来计算总的联合风险估计。通过每次剔除一项研究进行敏感性分析，并采用 Begg 和 Egger 检验评估发表偏倚。
有 6 项研究符合纳入标准，这 6 项研究共纳入 161305 例患者，其中 77920 例（48.31%）患者接受了他汀类药物治疗，83385 例（51.69%）患者接受了非他汀类药物治疗。有 4 项研究探讨了他汀类药物治疗对 ACS 患者新发 AF 的影响，另外 2 项研究描述了基线时伴有 AF 的 ACS 患者中他汀类药物治疗与 AF 发生之间的关系。与非他汀类药物治疗组相比，他汀类药物治疗组 AF 的发生率降低了 35%（95%可信区间：0.55-0.77，P<0.0001），并且他汀类药物治疗的效果似乎对新发 AF 更有益（RR=0.59，95%CI：0.48-0.73，p=0.096），而对 AF 的二级预防效果（RR=0.70，95%CI：0.43-1.14，p=0.085）则不明显。根据 Begg 和 Egger 检验，未发现发表偏倚（Begg，p=0.71；Egger，p=0.73）。
他汀类药物治疗可降低 ACS 患者心房颤动的风险。
