Prevention of atrial fibrillation recurrence by statin therapy in patients with lone atrial fibrillation after successful cardioversion

Siu, Chung‐Wah; Lau, Chu‐Pak; Tse, Hung‐Fat

doi:10.1016/j.amjcard.2003.08.023

Cited by 235 publications

(142 citation statements)

References 13 publications

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“…Siu et al, in a retrospective study with patients with lone AF, showed that AF recurrences were lower among the patients given simvastatin or atorvastatin treatment before cardioversion in comparison with the patients who did not receive lipid-lowering medications (42% vs 84%, P ¼ .032). 38 It is known that vitamin D suppresses pro-inflammatory cytokines and causes an increase in IL-10 levels. 6 Because of that effect, it is thought that vitamin D deficiency might be related to the development of and sustaining AF.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Vitamin D Deficiency on Atrial Fibrillation

Demir

Uyan

Melek

2012

Clin Appl Thromb Hemost

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Background: Vitamin D deficiency is associated with cardiovascular disease such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin-angiotensin-aldosterone system, which affects the cardiovascular system. For this reason, it could be suggested that there is a relationship between vitamin D deficiency and atrial fibrillation (AF). In our study, we compared 25-hydroxyvitamin D (25-OHD) levels between nonvalvular AF, valvular AF, and control groups in sinus rhythm. Method: A total of 102 patients with nonvalvular chronic AF without any other cardiovascular disease (mean age 62.51 + 5.88; group I) and 96 patients with AF, which is associated with mitral valve disease (mean age 61.51 + 5; group II) were included in our study. Of all, 100 age-matched healthy people with sinus rhythm were accepted as control groups (mean age 61.35 + 5.44). Routine biochemical parameters, 25-OHD and parathormone levels were performed. Results: Baseline characteristics of the study groups were comparable. Group I patients had a lower vitamin D level than group II and the control group (6.51 + 4.89, 9.24 + 7.39, and 11.18 + 6.98 ng/mL, P < .001, respectively). In groups I and II, the patients' left atrium diameter and systolic pulmonary artery pressure are higher than the control group. Conclusion: As a result, our study revealed a relationship between vitamin D deficiency and nonvalvular AF.

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Section: Discussionmentioning

confidence: 99%

The Effects of Vitamin D Deficiency on Atrial Fibrillation

Demir

Uyan

Melek

2012

Clin Appl Thromb Hemost

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“…Recent studies examining the relationship of statin therapy and AF have yielded conflicting results, partly because of small sample size. [8][9][10] We set out to evaluate the association of statin therapy and the risk of developing AF in patients implanted with permanent pacemakers, a population with a high incidence of AF. [11][12][13] …”

Section: Introductionmentioning

confidence: 99%

Association of statin therapy and the risk of atrial fibrillation in patients with a permanent pacemaker

Amit

Katz

Baron

et al. 2006

Clinical Cardiology

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SummaryBackground: Recent studies have shown conflicting results regarding a protective effect of statin therapy on atrial fibrillation (AF).Hypothesis: We sought to determine whether statins are effective in reducing the risk of developing arrhythmia in a cohort of 264 patients (49% women, mean age [± standard deviation] 71 [± 12] years) with permanent pacemakers who are at high risk for AF.Methods: All patients who underwent implantation of a permanent pacemaker over a 3-year period were eligible for inclusion in the study. We excluded patients with AF at implantation, incomplete medication information, or less than a yearly follow-up visit. Atrial fibrillation was diagnosed by ECG documentation, pacemaker interrogation, and Holter monitoring. Statin treatment was verified through a central pharmacy-computerized database (for most patients) or by chart review. Of the 264 patients, 36% had coronary artery disease.Results: Atrial fibrillation developed in 70 patients (26%) at a median of 359 days post pacemaker implantation. The incidence rate for the first occurrence of AF post pacemaker implantation among patients treated and not treated with statins was 10.5 versus 9.8 events per 100 patient-years, respectively

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“…The benefit of statin therapy seemed more marked in the postoperative 37) and secondary prevention of AF. 9) Previous clinical studies evaluating the efficacy of atorvastatin and pravastatin on recurrence of AF have been conducted in patients with paroxysmal form, 39) persistent form lasting 48 hours or longer after electrical cardioversion, [40][41][42] and postoperative AF 43) over short follow-up periods 39,40,42,43) (Table IIIB). In contrast, few studies have examined the efficacy of statins in patients with paroxysmal 44) and persistent AF on a long-term basis (> 2 years).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, few studies have examined the efficacy of statins in patients with paroxysmal 44) and persistent AF on a long-term basis (> 2 years). 41,45) Pravastatin, a hydrophilic statin, was considered to be effective for preventing recurrence of AF after electrical cardioversion in a retrospective study, whereas its efficacy was neglected in a randomized open-label multicenter study. 42) However, atorvastatin, a lipophilic statin, was demonstrated to be effective for preventing recurrence of paroxysmal and persistent AF in a prospective randomized study.…”

Section: Discussionmentioning

confidence: 99%

Long-term Efficacy of Upstream Therapy With Lipophilic or Hydrophilic Statins on Antiarrhythmic Drugs in Patients With Paroxysmal Atrial Fibrillation Comparison Between Atorvastatin and Pravastatin

et al. 2011

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SummaryThere is little information available on the benefits of selection of statins as upstream therapy for the prevention of paroxysmal atrial fibrillation (AF). We compared the efficacy and safety of atorvastatin (A-group, n = 43) and pravastatin (P-group, n = 41) as upstream therapy in patients with paroxysmal AF and dyslipidemia. A total of 84 patients (45 men, mean age, 66 ± 9 years, mean follow-up, 49 ± 32 months) were retrospectively assigned to receive atorvastatin (n = 41;10 mg/day) or pravastatin (n = 43 ; 10 mg/day). Survival rates free from AF recurrence at 1, 6, 12, and 24 months were 93%, 74%, 60%, and 53% in A-group, and 88%, 49%, 37%, and 29%, respectively, in P-group (P = 0.029, Agroup versus P-group). Survival rates free from conversion to permanent AF at 12, 36, 60, and 90 months were 100%, 100%, 98%, and 95% in A-group, and 100%, 95%, 88%, and 83%, respectively, in P-group (P = 0.063, A-group versus P-group). Using a logistic regression model, atorvastatin was found to be associated with a significantly reduced risk of AF recurrence in comparison to pravastatin (unadjusted odds ratio [OR] = 0.27, 95% confidence interval 0.11-0.68, P = 0.005). This association remained significant after adjustment for potentially confounding variables (OR = 0.26, 95% CI 0.08-0.86, P = 0.027). Using a logistic regression model, atorvastatin was not associated with a significantly reduced risk of converting to permanent AF in comparison to pravastatin (unadjusted OR = 0.29, 95% CI 0.05-1.50, P = 0.138), but this association did show a significant difference after adjustment for potentially confounding variables in a multivariate model (OR = 0.08, 95% CI 0.06-0.96, P = 0.046). Adverse effects requiring discontinuation of statins were observed in 1 case (2%, myalgia) in A-group, and 1 case (2%, elevation in CPK level ≥ 500 IU/L) in P-group, respectively (P = NS, A-group versus P-group). Atorvastatin, a lipophilic statin, was considered to be more effective in preventing recurrence of paroxysmal AF and conversion to permanent AF than pravastatin, a hydrophilic statin. (Int Heart J 2011; 52: 359-365)

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Prevention of atrial fibrillation recurrence by statin therapy in patients with lone atrial fibrillation after successful cardioversion

Cited by 235 publications

References 13 publications

The Effects of Vitamin D Deficiency on Atrial Fibrillation

The Effects of Vitamin D Deficiency on Atrial Fibrillation

Association of statin therapy and the risk of atrial fibrillation in patients with a permanent pacemaker

Long-term Efficacy of Upstream Therapy With Lipophilic or Hydrophilic Statins on Antiarrhythmic Drugs in Patients With Paroxysmal Atrial Fibrillation Comparison Between Atorvastatin and Pravastatin

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