NEW YORK (Reuters Health) – Statins reduce the risk of new-onset atrial fibrillation after myocardial infarction or revascularization, new data confirm.

“This may be yet another reason why everyone with coronary artery disease should be on statins,” senior author Dr. Niteesh K. Choudhry, from Brigham and Women’s Hospital in Boston, told Reuters Health.

However, there is not enough evidence to recommend statins for all patients at risk of atrial fibrillation, Dr. Choudhry added.

Markers of inflammation are elevated in patients with atrial fibrillation – and statins have anti-inflammatory properties, he added. To see whether statins could help lower the risk of atrial fibrillation, Dr. Choudhry and colleagues analyzed data on 29,088 Medicare beneficiaries, age 65 or older, with no history of the arrhythmia before or during hospitalization for myocardial infarction or revascularization. The mean follow-up for the entire cohort was 3.8 years.

Within one month of discharge, 8450 subjects (29%) received a prescription for a statin, according to the April 26 online report in the American Journal of Cardiology.

Within a year, atrial fibrillation developed in 10.6% of the statin group and 12.9% of the no-statin group. In the statin and no-statin groups, respectively, rates of new-onset atrial fibrillation were 32.6% and 51.2%, respectively, at 5 years and 38.3% and 58.0%, respectively, at 10 years.

After adjusting for patient- and hospital-related characteristics and for predictors of health-seeking behavior, statin use was independently associated with a lower risk of new-onset atrial fibrillation (hazard ratio 0.90, p = 0.0006).

The result was the same in a propensity-matched cohort of 6743 pairs of statin users and non-users (adjusted HR 0.91).

The authors note that most AF episodes did not require hospital admission, suggesting that the patients’ coronary artery disease was stable at the time.

“This begins to give us some understanding of atrial fibrillation, especially in coronary artery disease,” Dr. Choudhry said. “It suggests that it may be important to target inflammation to prevent atrial fibrillation.”

Reference:

Am J Cardiol 2010.