The effects of statin on atrial fibrillation: a meta-analysis of published data from randomized controlled trials

Background: Some clinical and experimental studies have shown the use of statins could protect against AF, but there are not adequate data at present. Objectives: We performed a meta-analysis of randomized trials with statins on the endpoint of incidence of AF to estimate the impact of statin use on AF development. Methods: We searched PUBMED, EMBASE and the Cochrane controlled Trials Register (Cochrane Library Issue 4, 2010) up to November 2010 to identify studies covering the use of statins on atrial fibrillation. Results: In published data from nine short term trials (1044 patients, 421 AF), the effect of statins was significantly associated with a decreased risk of recurrence of AF (OR 0.43, 95% CI 0.25 to 0.73, P = 0.002). The result of OR was higher when studies with Jadad score <= 3 were excluded (OR 0.32, 95% CI 0.18 to 0.54, P <= 0.0001). Among four long term trials (12,442 patients, 618 AF), the effect of statins was associated with a decreased risk of recurrence of AF (OR 0.81, 95% CI 0.68 to 0.97, P = 0.02). In three long term trials of more intensive versus standard statin (9130 patients, 188 AF), there was no evidence of a reduction in the risk of AF (OR 1.05, 95% CI 0.79 to 1.40, P = 0.74). Conclusion: Our meta-analysis suggests that the use of statins may be associated with preventing AF in short term trials and long term trials, but in the long term trials of more intensive versus standard statin, there was no evidence of a reduction in the risk of AF. However, we still need large-scale randomized double blind statin trials with AF occurrence as the main endpoint in order to finally confirm the benefits of statin in AF patients.