CHADS2 Score, Statin Therapy, and Risks of Atrial Fibrillation

Mar 04, 2013
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Authors:
Hung CY, Lin CH, Loh EW, Ting CT, Wu TJ.
Citation:
Am J Med 2013;126:133-140.
Summary By:
Fred Morady, MD, FACC

Study Questions:

Do statins prevent atrial fibrillation (AF)?

Methods:

The subjects of this retrospective study were 27,002 patients ages ≥65 years (mean age 73 years) with hypertension and no history of AF, who were randomly selected from a national database in Taiwan. Statin use and CHADS2 scores were determined for all patients. The study endpoint was new-onset AF during a mean of 8.1 years of follow-up.

Results:

The mean CHADS2 score was 1.8. Overall, 8.9% of the cohort were statin users. After adjusting for comorbidities, statin use was associated with a 19% lower probability of new-onset AF. The annual incidence of new-onset AF was significantly lower among the statin users (0.85%) than among the statin nonusers (1.05%). However, the significant difference in new-onset AF between the two groups was limited to patients with a CHADS2 score ≥2.

Conclusions:

The authors concluded that statins prevent new-onset AF in elderly patients with hypertension who have a CHADS2 score ≥2.

Perspective:

Prior studies on the effect of statins on AF have presented conflicting results. The present study suggests that a difference in the number of comorbidities could at least partially explain the conflicting results. The most likely mechanisms by which statins might prevent AF are an anti-inflammatory effect and/or indirect effects on ion channel function.

Keywords: Risk, Follow-Up Studies, Ion Channels, Cardiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Comorbidity, Probability, Taiwan, Hypertension


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