Fauchier Laurent, Clementy Nicolas, Pierre Bertrand, Babuty Dominique
Service de Cardiologie B, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, Tours, France Faculté de Médecine Université François Rabelais, Tours, France.
J Atr Fibrillation. 2012 Aug 20;5(2):443. doi: 10.4022/jafib.443. eCollection 2012 Aug-Sep.
In the recent years, some clinical and experimental studies have suggested that the use of statins may protect against atrial fibrillation (AF). A relation between inflammation and the development of AF has been described, and the potent anti-inflammatory and antioxidant properties of statins may make them effective in preventing the development of AF. A global analysis of the literature suggests that the use of statins is associated with a decreased risk of incidence or recurrence of AF in some cases. However, this beneficial effect is not seen for all types of AF in all the patients. The use of statins seems associated 1) with a lack of benefit in primary prevention of AF, 2) with a significant but heterogeneous decreased risk of recurrence of AF in secondary prevention, and 3) with a very significant and homogeneous reduction for the risk of post operative AF. An intensive lipid lowering statin regimen does not provide greater protection against AF. Patients with coronary heart disease are curr ently treated with statins in most cases, and this may not have an impact on their treatment. In contrast, it remains to determine more accurately if statins may bring a significant benefit for some AF patients without any type of established atherosclerotic disease or with a low risk of atherogenesis. Since it remains uncertain whether the suppression of AF in these patients is beyond doubt beneficial, prescribing statins for this purpose alone should not be recommended at the present time.
近年来，一些临床和实验研究表明，使用他汀类药物可能预防心房颤动（AF）。炎症与AF的发生之间的关系已被描述，他汀类药物强大的抗炎和抗氧化特性可能使其在预防AF发生方面有效。对文献的全面分析表明，在某些情况下，使用他汀类药物与AF发病率或复发风险降低有关。然而，并非所有类型的AF患者都能看到这种有益效果。他汀类药物的使用似乎与以下情况相关：1）在AF的一级预防中缺乏益处；2）在二级预防中，AF复发风险显著降低但存在异质性；3）在术后AF风险方面有非常显著且一致的降低。强化降脂他汀治疗方案并不能为预防AF提供更大的保护。大多数情况下，冠心病患者目前接受他汀类药物治疗，这可能对其治疗没有影响。相比之下，对于一些没有任何既定动脉粥样硬化疾病或动脉粥样硬化发生风险较低的AF患者，他汀类药物是否能带来显著益处仍有待更准确地确定。由于尚不确定在这些患者中抑制AF是否无疑有益，目前不应仅为此目的推荐使用他汀类药物。
