Non-influence of lipid lowering therapy in atrial fibrillation recurrence

摘要

Statin therapy has been associated with a reduction in ventricular and supra-ventricular tachyarrhythmias [1,2]. Statin therapy has also been associated with a lower risk of new onset AF in the elderly [3]. However, a recent meta-analysis showed reduction of secondary AF events but no reduction of new onset AF with statin use [4]. There is considerable debate with respect to the antiarrhythmic effects of statin therapy in AF. We determined the association of lipid lowering therapy (LLT) in prevention of AF recurrence in a large high-risk patient population with AF, most of whom were on statin [5].We performed a post hoc analysis of patients enrolled in the atrial fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial. A public-use limited-access dataset that was devoid of all patient identifiers was obtained from the National Heart, Lung and Blood Institute (NHLBI). AFFIRM was a prospective trial (n = 4060) comparing survival in patients with AF and at least one risk factor for stroke randomized to a strategy of rate control (n = 2027) versus a strategy of rhythm control (n = 2033) [6,7]. Our inclusion criteria included subjects in sinus rhythm at baseline (n = 2095). The primary end point of our analysis was the time to first AF recurrence (in months).