Key result
Statin therapy did not significantly reduce the risk of developing atrial fibrillation in patients with a permanent pacemaker (10.5 vs 9.8 events per 100 patient-years; HR 0.59, 95% CI 0.31-1.12).
Why the study?
Does statin therapy reduce the risk of developing atrial fibrillation in patients with a permanent pacemaker?
Cohort (n=264)
Does statin therapy reduce the risk of developing atrial fibrillation in patients with a permanent pacemaker?
Hazard Ratio: 0.59 (95% CI 0.31–1.12)
Absolute Event Rate: 10.5% vs 9.8%
p-value: p=0.81
Statin therapy was not associated with a significantly reduced risk of developing atrial fibrillation in patients with permanent pacemakers.
No support for statin use to prevent AF in pacemaker patients; hypothesis-generating and requires prospective confirmation.
BACKGROUND: 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 (p = 0.81). Even after controlling for baseline differences, the hazard ratio (HR) for developing AF among statin users did not achieve statistical significance (HR = 0.59 [0.31-1.12]). CONCLUSIONS: We could not demonstrate that statin therapy had a protective effect against the risk of AF in patients implanted with a permanent pacemaker. The low prevalence of coronary artery disease in our patients may partly explain our results.
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Amit et al. (2006) conducted a cohort in Permanent pacemaker (n=264). Statin therapy vs. No statin therapy was evaluated on First occurrence of atrial fibrillation post pacemaker implantation (HR 0.59, 95% CI 0.31-1.12, p=0.81). Statin therapy did not significantly reduce the risk of developing atrial fibrillation in patients with a permanent pacemaker (10.5 vs 9.8 events per 100 patient-years; HR 0.59, 95% CI 0.31-1.12).
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