Summary
Statins have important pleiotropic effects and have been shown to reduce vascular
inflammation. Some evidence suggests that statins may have a role in the primary prevention
of atrial fibrillation (AF), whereas little is know on the role of statins in patients
with existing AF. We performed a meta-analysis of the literature to assess the effect
of statins on the recurrence of AF after electrical cardioversion or ablation. MEDLINE
and EMBASE databases were searched up to January 2010. Relative risks (RR) and 95%
confidence intervals (CIs) were then calculated and pooled using a random-effects
model. Statistical heterogeneity was evaluated through the use of I2 statistics. Sixteen
studies were included in our systematic review. Statins did not reduce the risk of
AF recurrence after ablation (four studies including 750 patients; RR, 1.04; 95% CI,
0.85–1.28, p=0.71; I2 = 34%). Conversely, the use of statins was associated with a significantly reduced
risk of AF recurrence after electrical cardioversion (12 studies including 1790 patients;
RR, 0.78; 95% CI, 0.67–0.90, p=0.0003; I2 = 34%). This reduction was not statistically significant when the analysis was restricted
to randomised controlled trials (RCTs) only (five studies, 458 patients, RR, 0.76;
95% CI, 0.48–1.20). In conclusion, statins may lower the risk of AF recurrence after
electrical cardioversion, but not ablation. However, this finding should be considered
with caution, and larger RCTs are warranted to confirm our preliminary results.
Keywords
Statins - atrial fibrillation
