Atrial fibrillation and inflammation

Table 1 Statins and atrial fibrillation

Ref.	Study design	Subjects	Conclusion
Kumagai et al[21]	Prospective	Interventional canine sterile pericarditis model; atorvastatin	Atorvastatin group had lower CRP, shorter duration of AF, less inflammation in atrial tissues
Siu et al[25]	Retrospective	62 lone persistent AF, statin vs control	Lower recurrence rate in the statin group
Tveit et al[35]	Prospective	114 patients undergoing electrical cardioversion; pravastatin vs none	Pravastatin did not reduce the recurrence rate of AF
Young-Xu et al[26]	Prospective	449 patients with CAD were followed for 5 yr	Development of AF was lower in statin group
Ozaydin et al[24]	Prospective	48 patients undergoing cardioversion; atorvastatin vs none	81% relative risk reduction in AF recurrence
Ozaydin et al[31]	Observational	264 patients undergoing CABG surgery; any statin	Statin group had lower AF rates
Patti et al[30] (ARMYDA-3)	Prospective	200 patients undergoing CABG surgery; atorvastatin vs placebo	61% reduction in the odds of AF
García-Fernández et al[36]	Prospective	52 patients undergoing cardioversion; atorvastatin vs none	No significant difference in recurrence rate of AF
Ramani et al[27]	Retrospective	1526 patients with ACS; various statins	43% reduction in the odds
Humphries et al[37]	Prospective, observational	625 patiens undergoing cardioversion; any statin	74% reduction in the odds of AF with β-blocker; no effect alone
Hanna et al[42]	Data from a multicenter registry	25 268 patients with LVEF ≤ 40%	Lipid-lowering drug use was associated with reduced odds of AF
Fauchier et al[43]	Meta-analysis	Six studies with 3557 patients	Statins were significantly associated with a decreased risk of AF (P = 0.02)
			Benefit of statins was more marked in secondary prevention of AF
Liu et al[44]	Meta-analysis	Six randomized and 10 observational studies with 7041 patients	No significant effect of statins on AF development (P = 0.09). Observational studies showed that statin use decrease the relative risk for AF by 23%. This effect was greatest in the postoperative patients
Patel et al[46]	Meta-analysis	14 trials with 7402 patients	Statin decreased AF rates by 45%. Decrease was most prominent in postoperative AF
Marín et al[32]	Prospective, observational	234 patients undergoing CABG surgery; any statin	48% reduction in the odds of AF
McLean et al[40]	Two large, randomized trials: PROVE IT-TIMI 22 and A to Z trial	8659 patients with ACS; low- vs high-dose statin therapy	Neither study showed decreased AF risk with high-dose statin therapy
Lertsburapa et al[33]	Observational	555 patients undergoing CABG surgery; any statin	40% reduction in the odds of AF
Kourliouros et al[34]	Retrospective	680 patients undergoing CABG surgery; atorvastatin and simvastatin	Improving benefits with higher dose
Virani et al[39]	Retrospective	4044 patients undergoing CABG surgery; any statin	No effect
Adabag et al[41]	Cohort	13 783 CAD patients	No difference in AF incidence with statin treatment (P = 0.09). However, AF was reduced in a subgroup of patients with congestive heart failure (P = 0.04)

AF: Atrial fibrillation; CABG: Coronary artery bypass grafting; CAD: Coronary artery disease; CRP: C-reactive protein; ACS: Acute coronary syndrome; LVEF: Left ventricular ejection fraction.