他汀类药物治疗心房颤动随机对照试验Meta分析.pdfVIP

The Role of Statin Therapy in the Prevention of Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials Fang Wen-tong (Department of Pharmacy, The first affiliated hospital with nanjing medical university, Nanjing, Jiangsu, PR China; 210029;) 他汀类药物治疗心房颤动的随机对照试验的Meta 分析 房文通 （江苏省人民医院、南京医科大学第一附属医院药学部，南京，210029 ） Summary Aims To examine whether statins can reduce the risk of atrial fibrillation (AF). Background The use of statins had been suggested to protect against AF in some clinical observational and experimental studies but has remained inadequately explored. Methods Meta analysis of randomized, controlled trials with use of statins on incidence or recurrence of AF was performed. Results 20 studies with 23577 patients were included in the analysis. 7 studies investigated the use of statins in patients with AF, 11 studies investigated the primary prevention of statins in patients without AF, and 2 studies investigated mix population patients. Incidence or recurrence of AF occurred in 1543 patients. Overall, statins therapy was significantly associated with a decreased risk of AF compared with control (OR 0.49, 95% CI 0.37 to 0.65, p 0.00001). Beneficial effect was found in atorvastatin subgroup and simvastatin subgroup, but not found in pravastatin subgroup and rosuvastatin subgroup. Benefit of statin therapy seemed more markedly in secondary prevention (OR 0.34, 95% CI 0.18 to 0.64, p0.0008) than primary prevention (OR 0.54, 95% CI 0.40 to 0.74, p 0.0001). Conclusions Statin therapy was significantly associated with a decreased risk of incidence or recurrence of AF. Heterogeneity was explained by differences in statin types, patient population and surgery types. Benefit of statin therapy seemed more markedly in secondary prevention than primary preventio