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Published on: February 26, 2013
Statin Therapy Is Associated With a Lower Risk of Heart Failure in Patients With Atrial Fibrillation: A
Jia-Yi Huang1,2, Yap-Hang Chan2, Yi-Kei Tse2
1Division of Cardiology, Department of Medicine The University of Hong Kong Shen Zhen Hospital Hong Kong China.
Insights
Statin use significantly lowers heart failure risk in atrial fibrillation patients. This benefit increases with longer statin duration, suggesting a protective effect over time.
Area of Science:
- Cardiology
- Pharmacology
- Epidemiology
Background:
- Controversy exists regarding statin's role in reducing heart failure (HF) risk.
- This study investigates the association between statin therapy and HF incidence in patients with atrial fibrillation (AF).
Purpose of the Study:
- To evaluate the impact of statin use on the risk of developing incident heart failure among individuals diagnosed with atrial fibrillation.
Main Methods:
- Utilized a cohort of newly diagnosed atrial fibrillation patients (2010-2018).
- Employed inverse probability of treatment weighting for covariate balancing between statin users (n=23,239) and non-users (n=29,251).
- Assessed incident HF risk using Cox proportional hazard models and competing risk regression.
Main Results:
- Over a median follow-up of 5.1 years, incident HF occurred in 15.8% of statin users versus 19.1% of non-users.
- Statin use was linked to a 19% reduced risk of HF (aSHR, 0.81; 95% CI, 0.78-0.85).
- A duration-dependent reduction in HF risk was observed with longer statin use.
Conclusions:
- Statin therapy is associated with a decreased risk of incident heart failure in patients with atrial fibrillation.
- The protective effect of statins on HF risk appears to be duration-dependent, with longer use conferring greater benefit.
Background:
Whether statin use can reduce the risk of heart failure (HF) remains controversial. The present study evaluates the association between statin use and HF in patients with atrial fibrillation.
Methods And Results:
Patients with newly diagnosed atrial fibrillation from 2010 to 2018 were included. An inverse probability of treatment weighting was used to balance baseline covariates between statin users (n=23 239) and statin nonusers (n=29 251). The primary outcome was incident HF. Cox proportional hazard models with competing risk regression were used to evaluate the risk of HF between statin users and nonusers. The median age of the cohort was 74.7 years, and 47.3% were women. Over a median follow-up of 5.1 years, incident HF occurred in 3673 (15.8%) statin users and 5595 (19.1%) statin nonusers. Statin use was associated with a 19% lower risk of HF (adjusted subdistribution hazard ratio, 0.81 [95% CI, 0.78-0.85]). Restricted to the statin users, duration of statin use was measured during follow-up; compared with short-term use (3 months to <2 years), there was a stepwise reduction in the risk of incident HF among those with 2 to <4 years of statin use (subdistribution hazard ratio, 0.86 [95% CI, 0.84-0.88]), 4 to <6 years of statin use (subdistribution hazard ratio, 0.74 [95% CI, 0.72-0.76]), and ≥6 years of statin use (subdistribution hazard ratio, 0.71 [95% CI, 0.69-0.74]). Subgroup analysis showed consistent reductions in the risk of HF with statin use.
Conclusions:
Statin use was associated with a decreased risk of incident HF in a duration-dependent manner among patients with atrial fibrillation.
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