Statin drugs do not prevent atrial fibrillation

OXFORD, UNITED KINGDOM. Several short-term, small-scale trials have shown a beneficial effect of statin therapy in patients undergoing cardioversion or cardiac surgery. Based on the outcome of these trials, it has been assumed that statins are effective in preventing atrial fibrillation (AF) in general. A group of researchers from the University of Oxford, Royal Darwin Hospital (Australia), University Medical Center Utrecht (the Netherlands), University of Wurzburg (Germany), and the University of Glasgow now report that statin drugs are ineffective in preventing both new-onset and recurrent AF.

Their meta-analysis included over 130,000 participants who were followed for an average of 4 years. (NOTE: The above-mentioned short-term studies had an average follow-up of less than 4 months). Twenty-two of the studies included in the meta-analysis compared statin treatment to placebo treatment, while 9 studies compared standard statin therapy to intensified therapy (high dosage). In the statin/placebo trials a total of 2,535 AF events were documented – 1,240 in the statin group and 1,295 in the placebo group – a statistically non-significant difference. In the 9 statin/intensified statin trials, a total of 1,419 events were documented – 710 in the standard therapy group and 709 in the intensified therapy group – again, no statistically significant difference.

There was no evidence that statins were effective in preventing a first AF episode nor was there any evidence that the effect, or lack of it, of statins was different in patients with and without heart disease. The researchers speculate that the myth that statin drugs are effective in preventing AF may, at least in part, be due to publication bias (that is, the tendency for trial results to be more likely to be published if they have strikingly positive results than if the results are negative or null). They conclude that “Statins cannot currently be recommended for prevention of incident or recurrent atrial fibrillation.”

Rahimi, K, Macfarlane, PW, et al. Effect of statins on atrial fibrillation: collaborative meta-analysis of published and unpublished evidence from randomised controlled trials. British Medical Journal, Vol. 342, March 16, 2011

Editor’s comment: It is good to see the “statin myth” exposed once again. Certainly there is no valid reason whatsoever why an afibber would want to take them in the hope that they would alleviate or prevent AF episodes.