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Effects of Statins on First and Recurrent Supraventricular Arrhythmias in Patients With Mild Heart Failure (from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)

Published:October 06, 2015DOI:https://doi.org/10.1016/j.amjcard.2015.09.027
      Previous studies suggested that statin therapy reduces the risk of occurrence and recurrence of atrial fibrillation mainly in patients with coronary artery disease. Data regarding the effect of statins on the risk for the entire range of supraventricular arrhythmias (SVA) in mild heart failure (HF) with different disease causes are lacking. Multivariate Cox proportional hazards regression models were used to assess the effect of statin therapy, evaluated as a time-dependent covariate, on the risk of SVA and recurrent SVA (defined as atrial fibrillation, atrial flutter, atrial tachycardia, and supraventricular tachycardia) that were inappropriately treated with implantable cardioverter-defibrillator device in 1,790 patients enrolled in the Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy trial. Statin users constituted 68% of the study patients (n = 1209). They were older and more frequently men; they were more likely to have ischemic cardiomyopathy, diabetes, hypertension, and previous atrial arrhythmias. During the 3.7-year median follow-up time, 160 patients had an SVA event, and the total number of recurrent events was 335. Time-dependent statin therapy was independently associated with a significant 29% reduction of the first SVA event (p = 0.046) and 33% reduction of recurrent SVA events (p = 0.003), consistent across all prespecified subgroups. In conclusion, in mild HF with either cardiac resynchronization therapy with a defibrillator or an implantable cardioverter-defibrillator device, statin therapy was associated with significant reduction of occurrence and recurrence of inappropriately treated SVA.
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      References

        • Siu C.W.
        • Lau C.P.
        • Tse H.F.
        Prevention of atrial fibrillation recurrence by statin therapy in patients with lone atrial fibrillation after successful cardioversion.
        Am J Cardiol. 2003; 92: 1343-1345
        • Young-Xu Y.
        • Jabbour S.
        • Goldberg R.
        • Blatt C.M.
        • Graboys T.
        • Bilchik B.
        • Ravid S.
        Usefulness of statin drugs in protecting against atrial fibrillation in patients with coronary artery disease.
        Am J Cardiol. 2003; 92: 1379-1383
        • Amar D.
        • Zhang H.
        • Heerdt P.M.
        • Park B.
        • Fleisher M.
        • Thaler H.T.
        Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein.
        Chest. 2005; 128: 3421-3427
        • Dernellis J.
        • Panaretou M.
        Effect of C-reactive protein reduction on paroxysmal atrial fibrillation.
        Am Heart J. 2005; 150: 1064.e7-1064.e12
        • Marin F.
        • Pascual D.A.
        • Roldan V.
        • Arribas J.M.
        • Ahumada M.
        • Tornel P.L.
        • Oliver C.
        • Gómez-Plana J.
        • Lip G.Y.
        • Valdés M.
        Statins and postoperative risk of atrial fibrillation following coronary artery bypass grafting.
        Am J Cardiol. 2006; 97: 55-60
        • Ozaydin M.
        • Varol E.
        • Aslan S.M.
        • Kucuktepe Z.
        • Dogan A.
        • Ozturk M.
        • Altinbas A.
        Effect of atorvastatin on the recurrence rates of atrial fibrillation after electrical cardioversion.
        Am J Cardiol. 2006; 97: 1490-1493
        • Hanna I.R.
        • Heeke B.
        • Bush H.
        • Brosius L.
        • King-Hageman D.
        • Dudley Jr., S.C.
        • Beshai J.F.
        • Langberg J.J.
        Lipid-lowering drug use is associated with reduced prevalence of atrial fibrillation in patients with left ventricular systolic dysfunction.
        Heart Rhythm. 2006; 3: 881-886
        • Patti G.
        • Chello M.
        • Candura D.
        • Pasceri V.
        • D'Ambrosio A.
        • Covino E.
        • Di Sciascio G.
        Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia after cardiac surgery) study.
        Circulation. 2006; 114: 1455-1461
        • Tamargo J.
        • Caballero R.
        • Gomez R.
        • Nunez L.
        • Vaquero M.
        • Delpon E.
        Lipid-lowering therapy with statins, a new approach to antiarrhythmic therapy.
        Pharmacol Ther. 2007; 114: 107-126
        • Seferovic P.M.
        • Ristic A.D.
        • Maksimovic R.
        • Simeunovic D.S.
        • Ristic G.G.
        • Radovanovic G.
        • Seferović D.
        • Maisch B.
        • Matucci-Cerinic M.
        Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases.
        Rheumatol (Oxford). 2006; 45: iv39-iv42
        • Lazzerini P.E.
        • Capecchi P.L.
        • Guideri F.
        • Acampa M.
        • Galeazzi M.
        • Laghi Pasini F.
        Connective tissue diseases and cardiac rhythm disorders: an overview.
        Autoimmun Rev. 2006; 5: 306-313
        • Moss A.J.
        • Brown M.W.
        • Cannom D.S.
        • Daubert J.P.
        • Estes M.
        • Foster E.
        • Greenberg H.M.
        • Hall W.J.
        • Higgins S.L.
        • Klein H.
        • Pfeffer M.
        • Wilber D.
        • Zareba W.
        Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT): design and clinical protocol.
        Ann Noninvasive Electrocardiol. 2005; 10: 34-43
        • Moss A.J.
        • Hall W.J.
        • Cannom D.S.
        • Klein H.
        • Brown M.W.
        • Daubert J.P.
        • Estes 3rd, N.A.
        • Foster E.
        • Greenberg H.
        • Higgins S.L.
        • Pfeffer M.A.
        • Solomon S.D.
        • Wilber D.
        • Zareba W.
        • MADIT-CRT Trial Investigators
        Cardiac-resynchronization therapy for the prevention of heart-failure events.
        N Engl J Med. 2009; 361: 1329-1338
        • Moss A.J.
        • Brown M.W.
        • Cannom D.S.
        • Daubert J.P.
        • Estes M.
        • Foster E.
        • Greenberg H.M.
        • Hall W.J.
        • Higgins S.L.
        • Klein H.
        • Pfeffer M.
        • Wilber D.
        • Zareba W.
        Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT): design and clinical protocol.
        Ann Noninvasive Electrocardiol. 2005; 10: 34-43
        • Prentice R.L.
        • Williams B.J.
        • Peterson A.V.
        On the regression analysis of multivariate failure time data.
        Biometrika. 1981; 68: 373-379
        • Therneau T.M.
        • Grambsch P.M.
        Modeling Survival Data: Extending the Cox Model.
        Springer Science & Business Media, New York2000
        • Watanabe T.
        • Takeishi Y.
        • Hirono O.
        • Itoh M.
        • Matsui M.
        • Nakamura K.
        • Tamada Y.
        • Kubota I.
        C-reactive protein elevation predicts the occurrence of atrial structural remodeling in patients with paroxysmal atrial fibrillation.
        Heart Vessels. 2005; 20: 45-49
        • Sawaya S.E.
        • Rajawat Y.S.
        • Rami T.G.
        • Szalai G.
        • Price R.L.
        • Sivasubramanian N.
        • Mann D.L.
        • Khoury D.S.
        Downregulation of connexin40 and increased prevalence of atrial arrhythmias in transgenic mice with cardiac-restricted overexpression of tumor necrosis factor.
        Am J Physiol Heart Circ Physiol. 2007; 292: H1561-H1567
        • Henningsen K.M.
        • Therkelsen S.K.
        • Bruunsgaard H.
        • Krabbe K.S.
        • Pedersen B.K.
        • Svendsen J.H.
        Prognostic impact of hs-CRP and IL-6 in patients with persistent atrial fibrillation treated with electrical cardioversion.
        Scand J Clin Lab Invest. 2009; 69: 425-432
        • Conway D.S.
        • Buggins P.
        • Hughes E.
        • Lip G.Y.
        Relationship of interleukin-6 and C-reactive protein to the prothrombotic state in chronic atrial fibrillation.
        J Am Coll Cardiol. 2004; 43: 2075-2082
        • Marcus G.M.
        • Smith L.M.
        • Ordovas K.
        • Scheinman M.M.
        • Kim A.M.
        • Badhwar N.
        • Lee R.J.
        • Tseng Z.H.
        • Lee B.K.
        • Olgin J.E.
        Intracardiac and extracardiac markers of inflammation during atrial fibrillation.
        Heart Rhythm. 2010; 7: 149-154
        • Aviles R.J.
        • Martin D.O.
        • Apperson-Hansen C.
        • Houghtaling P.L.
        • Rautaharju P.
        • Kronmal R.A.
        • Tracy R.P.
        • Van Wagoner D.R.
        • Psaty B.M.
        • Lauer M.S.
        • Chung M.K.
        Inflammation as a risk factor for atrial fibrillation.
        Circulation. 2003; 108: 3006-3010
        • Ishii Y.
        • Schuessler R.B.
        • Gaynor S.L.
        • Yamada K.
        • Fu A.S.
        • Boineau J.P.
        • Damiano Jr., R.J.
        Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation.
        Circulation. 2005; 111: 2881-2888
        • Gaudino M.
        • Andreotti F.
        • Zamparelli R.
        • Di Castelnuovo A.
        • Nasso G.
        • Burzotta F.
        • Iacoviello L.
        • Donati M.B.
        • Schiavello R.
        • Maseri A.
        • Possati G.
        The -174G/C interleukin-6 polymorphism influences postoperative interleukin-6 levels and postoperative atrial fibrillation. Is atrial fibrillation an inflammatory complication?.
        Circulation. 2003; 108: II195-II199
        • Wang T.J.
        • Larson M.G.
        • Levy D.
        • Vasan R.S.
        • Leip E.P.
        • Wolf P.A.
        • D'Agostino R.B.
        • Murabito J.M.
        • Kannel W.B.
        • Benjamin E.J.
        Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study.
        Circulation. 2003; 107: 2920-2925
        • Anter E.
        • Jessup M.
        • Callans D.J.
        Atrial fibrillation and heart failure: treatment considerations for a dual epidemic.
        Circulation. 2009; 119: 2516-2525