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Thromb Haemost 2011; 106(02): 363-370
DOI: 10.1160/TH10-10-0660
Cardiovascular Biology and Cell Signalling
Schattauer GmbH

Use of statins and recurrence of atrial fibrillation after catheter ablation or electrical cardioversion

A systematic review and meta-analysis
Francesco Dentali
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Monica Gianni
2   Department of Cardiology, Hospital of Tradate, Varese, Italy
,
Alessandro Squizzato
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Walter Ageno
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Luana Castiglioni
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Lorenzo Maroni
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Elaine M. Hylek
3   Department of Medicine, Research Unit − Section of General Internal Medicine, Boston University Medical Center, Boston, Massachusetts, USA
,
Anna Maria Grandi
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Eugenio Cazzani
2   Department of Cardiology, Hospital of Tradate, Varese, Italy
,
Achille Venco
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
,
Luigina Guasti
1   Department of Clinical Medicine, University of Insubria, Varese, Italy
› Author Affiliations
Further Information

Publication History

Received: 17 October 2011

Accepted after major revision: 29 April 2011

Publication Date:
25 November 2017 (online)

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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

 

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