Effect Of Statin therapy On New-onset Atrial Fibrillation In General Population: A Nationwide Census Based Longitudinal Study

초록

Background: Statin is known as an upstream therapy for atrial fibrillation (AF). However, there is still debate whether the use of statins prevents new-onset AF. Objective: We investigated whether statin use could reduce incidence of new-onset AF. Methods: We studied 900,664 adults (mean age 40 ± 17 years, 407,152 women [45.2%]) without AF from Korea National Health Insurance Service database from 2008 to 2012. We divided them into two groups by statin treatment (group 1, subjects with statin treatment, n=84,690; group 2, without statin treatment, n=815,974). Incidence of new-onset AF was compared after propensity score (PS) matching (matched variables: age, sex, co-morbidities and all related medications, Standardized Difference of all variables<0.03). Results: During a mean follow-up of 8.4 ± 3.1years, AF developed in 9,136 patients. The overall incidence of AF for follow-up duration was 1.33 per 1,000 person-years. After PS matched, the incidence rate of AF in group 1 and 2 were 4.97(4.76-5.20) and 5.78(5.54-6.02) per 1000 person-years, respectively. In Cox proportional hazards models adjusted by the PS of receiving statin treatment, whereas hypertension (HR 13.25, 95% CI 10.63-16.51, p<0.001) and diabetes mellitus (HR 1.31, 95% CI 1.15-1.50, p<0.001) were significantly associated with new-onset AF, statin treatment did not reach statistical significance (HR 0.99, 95% CI 0.92-1.08, p=0.883). Conclusion: This study showed that, although the incidence of AF was lower in patients on statin use compared to those without statin, statin therapy did not reduce new-onset AF after adjusting relevant risk factors and related all other medications.