Impact of Prior Statin Therapy on Arrhythmic Events in Patients With Acute Coronary Syndromes (from the Global Registry of Acute Coronary Events [GRACE])

The preventive effect of statin therapy on new-onset and recurrent atrial fibrillation in patients not undergoing invasive cardiac interventions

“…To exclude possible bias due to invasive interventions associated with MI management, we performed a sub-analysis excluding MI studies [32][33][34][35]. This analysis showed a consistent significant effect of statins on risk reduction of AF (RR: 0.89 [95%CI: 0.86-0.92], p=0.002) in non-MI studies.…”

“…We assumed that the heterogeneity in the observational trials reflected the difference in the sample size and event rate of the large versus small size studies. Hence, a step-wise exclusion of large [23,34,35] or small size trials [27,28,30,40,44] did not improve the heterogeneity.…”

“…Six trials examined patients with coronary artery disease [18,19,[21][22][23][24][25], six trials examined effect of statins in patients undergoing electrical conversion [26][27][28][29][30][31], four trials were on patients with MI [32][33][34][35], and four trials were undertaken in patients with pacemaker or implantable cardioverter-defibrillator (ICD) [36][37][38][39]. Two trials analyzed primary prevention of AF [17,40], one trial was on patients with heart failure [20], one trial was on AF after cerebral infarction, [41] one trial investigated in elderly patients [32] and finally one trial examined patients with left ventricular hypertrophy [42].…”

The Pleiotropic Effects of the Hydroxy-Methyl-Glutaryl-CoA Reductase Inhibitors in Cardiovascular Disease

“…29 During the first 7 days of the postoperative period in patients assigned to daily atorvastatin, there was a prevalence of new-onset atrial fibrillation of 14% versus 32% for the control group (P ϭ 0.009), and a mean duration of single atrial fibrillation episodes of 3.6 hours versus 5.7 hours (P Ͻ 0.01). Furthermore, a recent observational study using data from 17,636 patients enrolled in Global Registry of Acute Coronary Events 30 showed that patients hospitalized for ACS who were taking statins were not only at a lower risk for developing in-hospital atrial fibrillation (P Ͻ 0.0001), but also demonstrated a significantly decreased risk of developing ventricular arrhythmias, cardiac arrest, and/or death.…”

Targeting the Arrhythmogenic Substrate in Atrial Fibrillation: Focus on Structural Remodeling

“…The recent multinational, prospective, observational GRACE (Global Registry of Acute Coronary Events) study, enrolling 64,679 hospitalized patients with suspected acute coronary syndromes, showed that previous intake of statins lowered the incidence of in-hospital arrhythmic events after acute coronary syndrome [309]. However, the heterogeneity of selected population and the retrospective nature of most studies do not allow to draw definite conclusion.…”