Cited by 159Atrial Fibrillation Management and OutcomesLipoproteins and Cardiovascular HealthAcute Myocardial Infarction Research

Effect of statins on atrial fibrillation: collaborative meta-analysis of published and unpublished evidence from randomised controlled trials

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Rahimi, K., Emberson, J., McGale, P., Majoni, W., Merhi, A., Asselbergs, F. W., Krane, V., Macfarlane, P. W. +1 more·2011·BMJ

Abstract

OBJECTIVE: To examine whether statins can reduce the risk of atrial fibrillation. DESIGN: Meta-analysis of published and unpublished results from larger scale statin trials, with comparison of the findings against the published results from smaller scale or shorter duration studies. DATA SOURCES: Medline, Embase, and Cochrane's CENTRAL up to October 2010. Unpublished data from longer term trials were obtained through contact with investigators. STUDY SELECTION: Randomised controlled trials comparing statin with no statin or comparing high dose versus standard dose statin; all longer term trials had at least 100 participants and at least six months' follow-up. RESULTS: In published data from 13 short term trials (4414 randomised patients, 659 events), statin treatment seemed to reduce the odds of an episode of atrial fibrillation by 39% (odds ratio 0.61, 95% confidence interval 0.51 to 0.74; P < 0.001), but there was significant heterogeneity (P < 0.001) between the trials. In contrast, among 22 longer term and mostly larger trials of statin versus control (105,791 randomised patients, 2535 events), statin treatment was not associated with a significant reduction in atrial fibrillation (0.95, 0.88 to 1.03; P = 0.24) (P<0.001 for test of difference between the two sets of trials). Seven longer term trials of more intensive versus standard statin regimens (28,964 randomised patients and 1419 events) also showed no evidence of a reduction in the risk of atrial fibrillation (1.00, 0.90 to 1.12; P = 0.99). CONCLUSIONS: The suggested beneficial effect of statins on atrial fibrillation from published shorter term studies is not supported by a comprehensive review of published and unpublished evidence from larger scale trials.

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  1. and their joint influence on mortality: the Framingham Heart Study. Circulation 2003;107:2920-5.
  2. Schwartz GG, Olsson AG, Chaitman J, Golberger M, Szarek M, Saseila WJ. Effect of intensive statin treatment on the occurence of atrial fibrillation after acute coronary syndrome: an analysis of the MIRACL trial. Circulation 2004;110:740.
  3. Tamayo E, Alonso O, Alvarez FJ, Castrodeza J, Florez S, di Stefano S. [Effects of simvastatin on acute-phase protein levels after cardiac surgery.] Med Clin (Barc) 2008;130:773-5.
  4. GISSI Prevenzione Investigators (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico). Results of the low-dose (20 mg) pravastatin GISSI prevenzione trial in 4271 patients with recent myocardial infarction: do stopped trials contribute to overall knowledge? Ital Heart J 2000;1:810-20.
  5. MRC/BHF. Heart protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo- controlled trial. Lancet 2002;360:7-22.

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Authors
Rahimi, K., Emberson, J., McGale, P., Majoni, W., Merhi, A., Asselbergs, F. W., Krane, V., Macfarlane, P. W., & Executive, P. I. A. O. B. O. T. P.
Affiliations
  • University of Oxford (GB)
  • Royal Darwin Hospital (AU)
  • University Medical Center Utrecht (NL)
  • University of Würzburg (DE)
Corresponding author
Rahimi, K.
Venue
BMJ
Publisher
BMJ
Published
2011-03-16
Volume
342
Issue
mar16 2
Pages
d1250-d1250
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2145838023
Cited by
159
References
93
Citations by year
2026: 4 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 10 · 2020: 12 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 14 · 2015: 12 · 2014: 11 · 2013: 19 · 2012: 23
FWCI
3.35
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • British Heart Foundation (RE/08/004)
  • ZonMw (90700342, ZonMw grant 90700342)
  • BHF Centre of Research Excellence, Oxford (RE/08/004)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
statins, atrial fibrillation, statin dose, unpublished data, trial heterogeneity, cardiovascular risk reduction, statin trials
MeSH terms
Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Risk Factors, Randomized Controlled Trials as Topic, Treatment Outcome, Publication Bias, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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