Effects of Rosuvastatin on Asymmetric Dimethylarginine Levels and Early Atrial Fibrillation Recurrence after Electrical Cardioversion

BACKGROUND: High levels of asymmetric dimethylarginine (ADMA) are associated with an increased risk of early recurrence of atrial fibrillation (AF) after electrical cardioversion. We aimed to investigate the effects of rosuvastatin on serum ADMA levels and early recurrence of AF following successful electrical cardioversion. METHODS: A total of 64 patients with persistent AF, but without known heart disease, who underwent elective electrical cardioversion were randomized to the rosuvastatin (group I, n = 32) and control (group II, n = 32) groups. The end point was the recurrence of AF during the 3 months of follow-up. RESULTS: The baseline ADMA levels were not different between the two groups. At the end of follow-up, serum ADMA levels in group I decreased compared with the baseline levels, whereas no significant change occurred in group II. During the follow-up, five patients in group I (15.6%) and 13 in group II (40.6%) had AF recurrence (P < 0.05, log-rank test). With the Cox proportional model, the predictors of recurrence included age > or =65 years, left atrial diameter >45 mm, and baseline ADMA levels > or =2.0 micromol/l. Rosuvastatin was associated with a reduced risk of AF recurrence (relative risk 0.35, 95% confidence interval 0.12-0.96, P < 0.05). CONCLUSIONS: Rosuvastatin decreased the early recurrence of AF following successful electrical cardioversion with reduced ADMA levels.