Heart 95:704-708 doi:10.1136/hrt.2008.154054
  • Original article
  • Heart rhythm disorders and pacemakers

Statin use is associated with lower risk of atrial fibrillation in women with coronary disease: the HERS trial

  1. C N Pellegrini1,
  2. E Vittinghoff2,
  3. F Lin2,
  4. S B Hulley2,
  5. G M Marcus1
  1. 1
    Division of Cardiology, Electrophysiology Section, University of California, San Francisco, California, USA
  2. 2
    Department of Epidemiology and Biostatics, University of California, San Francisco, California, USA
  1. Dr G M Marcus, 500 Parnassus Avenue, Room MUE434, Box 1354, San Francisco, CA 94143-1354, USA; marcusg{at}
  • Accepted 14 October 2008
  • Published Online First 28 January 2009


Objective: To determine the efficacy of statin treatment in atrial fibrillation (AF) prevention in women.

Design: Cohort study using data obtained in the Heart and Estrogen/Progestin Replacement Study (HERS).

Setting: Secondary analysis of a multicentre, randomised controlled clinical trial.

Patients: 2673 Postmenopausal women with coronary disease.

Main outcome measures: AF prevalence at baseline and incident AF over a mean follow-up of 4.1 years.

Results: 88 Women with AF were identified: 29 at baseline and 59 during follow-up. Women with AF were significantly less likely to be taking a statin at study enrolment than those without AF (22% vs 37%, p = 0.003). Baseline statin use was associated with a 65% lower odds of having AF at baseline after controlling for age, race, history of myocardial infarction or revascularisation and history of heart failure (odds ratio 0.35, 95% confidence interval (CI) 0.13 to 0.93, p = 0.04). The risk of developing AF during the study among those free from AF at baseline, adjusted for the same covariates, was 55% less for those receiving statin treatment (hazard ratio 0.45, 95% CI 0.26 to 0.78, p = 0.004).

Conclusions: Statin treatment is associated with a lower prevalence and incidence of AF after adjustment for potential confounders in postmenopausal women with coronary disease.


  • Funding: This work was made possible by a fellowship grant from the American Heart Association Western States Affiliate (CNP), grant number KL2 RR024130 from the National Center for Research Resources, a component of the NIH (GMM), and an American Heart Association Beginning Grant-in-Aid Award (GMM).

  • Competing interests: None.

  • Ethics approval: Ethics committee approval obtained.

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