Fiedler Lukas, Hallsson Lára, Tscharre Maximilian, Oebel Sabrina, Pfeffer Michael, Schönbauer Robert, Tokarska Lyudmyla, Stix Laura, Haiden Anton, Kraus Johannes, Blessberger Hermann, Siebert Uwe, Roithinger Franz Xaver
Department of Internal Medicine, Cardiology, Nephrology and Intensive Care Medicine, Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria.
Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria.
J Clin Med. 2021 Feb 17;10(4):807. doi: 10.3390/jcm10040807.
The relationship of statin therapy with recurrence of atrial fibrillation (AF) after cardioversion (CV) has been evaluated by several investigations, which provided conflicting results and particularly long-term data is scarce. We sought to examine whether upstream statin therapy is associated with long-term recurrence of AF after CV. This was a single-center registry study including consecutive AF patients ( = 454) undergoing CV. Cox regression models were performed to estimate AF recurrence comparing patients with and without statins. In addition, we performed a propensity score matched analysis with a 1:1 ratio. Statins were prescribed to 183 (40.3%) patients. After a median follow-up period of 373 (207-805) days, recurrence of AF was present in 150 (33.0%) patients. Patients receiving statins had a significantly lower rate of AF recurrence (log-rank < 0.001). In univariate analysis, statin therapy was associated with a significantly reduced rate of AF recurrence (HR 0.333 (95% CI 0.225-0.493), = 0.001), which remained significant after adjustment (HR 0.238 (95% CI 0.151-0.375), < 0.001). After propensity score matching treatment with statins resulted in an absolute risk reduction of 27.5% for recurrent AF (21 (18.1%) vs. 53 (45.7%); < 0.001). Statin therapy was associated with a reduced risk of long-term AF recurrence after successful cardioversion.
几项研究评估了他汀类药物治疗与心脏复律（CV）后房颤（AF）复发之间的关系，这些研究结果相互矛盾，尤其是长期数据匮乏。我们试图研究上游他汀类药物治疗是否与CV后AF的长期复发有关。这是一项单中心登记研究，纳入了连续接受CV的AF患者（n = 454）。采用Cox回归模型比较使用和未使用他汀类药物的患者，以估计AF复发情况。此外，我们进行了1:1比例的倾向评分匹配分析。183例（40.3%）患者使用了他汀类药物。中位随访期为373（207 - 805）天，150例（33.0%）患者出现AF复发。接受他汀类药物治疗的患者AF复发率显著较低（对数秩检验P < 0.001）。在单因素分析中，他汀类药物治疗与AF复发率显著降低相关（HR 0.333（95%CI 0.225 - 0.493），P = 0.001），调整后仍具有显著性（HR 0.238（95%CI 0.151 - 0.375），P < 0.001）。倾向评分匹配后，他汀类药物治疗使AF复发的绝对风险降低了27.5%（21例（18.1%） vs. 53例（45.7%）；P < 0.001）。他汀类药物治疗与成功心脏复律后长期AF复发风险降低有关。
