Among patients with CAD, ezetimibe/rosuvastatin was associated with reduced incident AF risk, whereas diltiazem, torasemide, heparin, bisoprolol, and norepinephrine increased risk.
Cohort (n=157,750)
Do specific cardiovascular medications modulate the risk of incident atrial fibrillation in patients with coronary artery disease?
In patients with CAD, specific medications are associated with varying risks of incident AF, with ezetimibe/rosuvastatin linked to lower risk and certain diuretics, antianginals, and vasoactive agents linked to higher risk.
Purpose Cardiovascular medications used in coronary artery disease (CAD) can potentially modulate the risk of incident atrial fibrillation (AF). However, comprehensive data regarding medication-specific AF risk in the CAD population remain limited. This study aimed to identify prevalent medications prescribed to patients with CAD and evaluate their independent associations with AF risk. In this retrospective cohort study of 157,750 patients with CAD and related comorbidities, CAD-predominant medications were identified based on a frequency analysis of prescriptions in the overall cohort. Among 99,370 patients who received at least one such medication, associations with incident AF were evaluated using extended Cox proportional hazards models with time-varying covariates. Overall, 30 CAD-predominant medications were identified across nine pharmacological classes. In multivariable Cox proportional hazards models, six medications were significantly associated with AF risk, of which one was associated with a lower risk and five with a higher risk. Ezetimibe/rosuvastatin was associated with reduced AF risk, whereas diltiazem HCl, torasemide, heparin sodium, bisoprolol fumarate, and norepinephrine were associated with increased risk. Torasemide showed the strongest positive association. AF risk demonstrated heterogeneity across different CAD medications. Antilipidemic agents were associated with a lower AF risk, whereas certain diuretics, antianginal agents, antihypertensive, and vasoactive agents were associated with a higher risk. These results may have implications for individualized pharmacotherapy and AF prevention in patients with CAD.
Kim et al. (Thu,) conducted a cohort in coronary artery disease (n=157,750). CAD-predominant medications was evaluated on incident atrial fibrillation. Among patients with CAD, ezetimibe/rosuvastatin was associated with reduced incident AF risk, whereas diltiazem, torasemide, heparin, bisoprolol, and norepinephrine increased risk.