Long-Term Statins may lower Risk of Adverse Events in Newly Diagnosed Atrial Fibrillation Patients: Study
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Taiwan: A recent study published in the Journal of the American Heart Association suggests that statins could play a crucial role in improving long-term outcomes for patients newly diagnosed with atrial fibrillation (AF).
"Statin use was linked to a 9% reduced risk of composite adverse outcomes, including ischemic and hemorrhagic strokes and transient ischemic attacks. Additionally, statin therapy was associated with a 67% decrease in all-cause mortality and a 36% reduction in major adverse cardiovascular events," the researchers reported.
According to the authors, this study represents the largest observational cohort of patients newly diagnosed with atrial fibrillation (AF) to explore the preventive effects of statin use on cardiovascular events. The key findings are as follows: regular statin use was linked to a significant reduction in the risk of stroke or transient ischemic attack (TIA); statin users consistently showed lower risks of all-cause mortality and major adverse cardiovascular events (MACEs) compared to nonusers, even after adjusting for important variables. Furthermore, a time-dependent analysis was performed to account for the timing of statin use, and the results consistently demonstrated a significant risk reduction.
The role of statins in preventing adverse cardiovascular events in individuals with atrial fibrillation has been unclear. Therefore, Ting‐Chun Huang, Institute of Clinical Medicine, College of Medicine National Cheng Kung University Tainan Taiwan, and colleagues aimed to determine whether statin use could improve outcomes in individuals with AF.
For this purpose, the researchers enrolled 397,787 patients with atrial fibrillation (AF) between 2012 and 2020. Participants were categorized into two groups: statin users and statin nonusers. The study analyzed the risks of composite outcomes—such as ischemic stroke, hemorrhagic stroke, and transient ischemic attack—along with all-cause mortality and major adverse cardiovascular events, including cardiovascular death, myocardial infarction, stroke, and heart failure hospitalization.
Among these, 288,958 patients had newly diagnosed AF (mean age 73 years; 44% women; mean CHA2DS2-VASc score 3.5). The researchers reported the following findings:
- Statin users had lower risks of composite endpoints compared to nonusers (adjusted HR, 0.91).
- Statin use was associated with a 67% reduction in all-cause mortality compared to nonusers (adjusted HR, 0.33).
- Statin use was linked to a reduced incidence of major adverse cardiovascular events (adjusted HR, 0.64).
- In subgroup analysis stratified by CHA2DS2-VASc scores, statin therapy was most effective for composite endpoints in patients, with scores between 0 and 3.
- Statin use consistently reduced all-cause mortality and major adverse cardiovascular events across all CHA2DS2-VASc score categories.
"Regular use of statins lowers the risk of stroke, mortality, and major adverse cardiovascular events in patients with newly diagnosed atrial fibrillation. However, further randomized trials are needed to confirm these findings," the researchers concluded.
Reference:
Huang TC, Yap LH, Chen CY, Lin HW, Lin SH, Li YH. Long-Term Statin Use Is Associated With Reduced Rates of Adverse Events in Patients With Newly Diagnosed Atrial Fibrillation. J Am Heart Assoc. 2024 Dec 17;13(24):e035827. doi: 10.1161/JAHA.124.035827. Epub 2024 Dec 14. PMID: 39673286.
