Veronese Giacomo, Montomoli Jonathan, Schmidt Morten, Horváth-Puhó Erzsébet, Sørensen Henrik Toft
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Am J Ther. 2015 May-Jun;22(3):186-94. doi: 10.1097/MJT.0b013e31827ab488.
The pleiotropic effects of statins have been suggested to prevent atrial fibrillation onset. We conducted a population-based case-control study using medical databases from Northern Denmark (population: 1.8 million) to examine the association between statin use and atrial fibrillation or flutter. We identified 51,374 patients with atrial fibrillation or flutter between 1999 and 2010 and 513,670 matched population controls. We collected data on statin prescriptions redeemed within 90 days (current users) or longer (former users) before the diagnosis date of atrial fibrillation or flutter. We stratified statin users by duration of exposure, determined by the number of days between first and last redeemed prescription before the diagnosis date (<365, 365-1094, and ≥1095 days). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs), controlling for potential confounders. We defined people without previous statin use as never users (reference). A total of 7360 (14.3%) cases and 55,699 (10.8%) controls were current statin users. Among current users (adjusted OR: 0.96, 95% CI, 0.93-0.99), the preventive effect of statins on atrial fibrillation or flutter was related to duration of use: adjusted ORs decreased from 1.35 (95% CI, 1.28-1.42) for users who were prescribed statins for <365 days to 0.85 (95% CI, 0.81-0.89) for users who were prescribed statins for ≥1095 days compared with never users. For former users (adjusted OR: 0.94, 95% CI. 0.90-0.98), the ORs did not change with varying lengths of exposure. In conclusion, long-term statin use may reduce the risk of atrial fibrillation or flutter compared with never use.
他汀类药物的多效性作用被认为可预防心房颤动的发生。我们利用丹麦北部的医学数据库（人口：180万）开展了一项基于人群的病例对照研究，以检验他汀类药物使用与心房颤动或心房扑动之间的关联。我们在1999年至2010年间确定了51374例心房颤动或心房扑动患者以及513670例匹配的人群对照。我们收集了在心房颤动或心房扑动诊断日期前90天内（当前使用者）或更长时间（既往使用者）所兑换的他汀类药物处方数据。我们根据暴露持续时间对他汀类药物使用者进行分层，暴露持续时间由诊断日期前首次和最后一次兑换处方之间的天数确定（<365天、365 - 1094天和≥1095天）。我们使用条件逻辑回归来计算比值比（OR）和95%置信区间（CI），并对潜在混杂因素进行控制。我们将既往未使用过他汀类药物的人定义为从未使用者（参照）。共有7360例（14.3%）病例和55699例（10.8%）对照为当前他汀类药物使用者。在当前使用者中（调整后的OR：0.96，95%CI，0.93 - 0.99），他汀类药物对心房颤动或心房扑动的预防作用与使用持续时间有关：与从未使用者相比，使用他汀类药物<365天的使用者调整后的OR从1.35（95%CI，1.28 - 1.42）降至使用他汀类药物≥1095天的使用者的0.85（95%CI，0.81 - 0.89）。对于既往使用者（调整后的OR：0.94，95%CI，0.90 - 0.98），OR并未随暴露时间的不同而变化。总之，与从未使用相比，长期使用他汀类药物可能降低心房颤动或心房扑动的风险。
