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Impact of early statin therapy on development of atrial fibrillation at the acute stage of myocardial infarction: data from the FAST-MI register
  1. Nicolas Danchin1,
  2. Laurent Fauchier2,
  3. Eloi Marijon1,
  4. Claude Barnay3,
  5. Alain Furber4,
  6. Philippe Mabo5,
  7. Paul Bernard6,
  8. Jean-Jacques Blanc7,
  9. Xavier Jouven1,
  10. Jean-Yves Le Heuzey1,
  11. Bernard Charbonnier2,
  12. Jean Ferrières8,
  13. Tabassome Simon9,
  14. for the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) Investigators*
  1. 1Cardiology Department, Hôpital Européen Georges Pompidou and Université Paris Descartes, Paris, France
  2. 2Centre Hospitalier Universitaire de Tours, Tours, France
  3. 3Centre Hospitalier Aix en Provence, Aix en Provence, France
  4. 4Centre Hospitalier Universitaire d'Angers, Angers, France
  5. 5Centre Hospitalier Universitaire de Rennes, Rennes, France
  6. 6Clinique du Pont de Chaume, Montauban, Montauban, France
  7. 7Centre Hospitalier Universitaire de Brest, Brest, France
  8. 8Centre Hospitalier Universitaire de Toulouse, Toulouse, France
  9. 9Hôpital St Antoine, AP-HP, URCEST, UPMC Université Paris 6, Paris, France
  1. Correspondence to Professor Nicolas Danchin, Division of Coronary Artery Disease and Intensive Cardiac Care, Hôpital Européen Georges Pompidou, Assistance-Publique des Hôpitaux de Paris and Faculté René Descartes, Université Paris 5, 20 rue Leblanc, 75015 Paris, France; nicolas.danchin{at}egp.aphp.fr

Abstract

Background Atrial fibrillation developing at the acute stage of myocardial infarction is associated with untoward clinical outcomes. The aim of this study was to determine correlations between early statin therapy and atrial fibrillation in acute myocardial infarction.

Methods Patients (3396) with sinus rhythm developing acute myocardial infarction were enrolled in the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI).

Results Atrial fibrillation developed in 7.0% of patients without and 3.9% of patients with early (≤48 h of admission) statin therapy (p<0.001). Multivariable analysis, including the propensity score for early statin treatment, showed that statin therapy was associated with reduced risk of atrial fibrillation (OR 0.64; 95% CI 0.45 to 0.92, p=0.017). Compared to patients without early statin therapy, the OR for atrial fibrillation were 0.72 (0.49 to 1.04, p=0.080), 0.52 (0.28 to 0.95, p=0.034) and 0.40 (0.18 to 0.92, p=0.030) in patients on conventional, intermediate and high doses respectively.

Conclusions This study is the first to document a correlation between early statin therapy and atrial fibrillation at the early stage of acute myocardial infarction.

  • Atrial fibrillation
  • statin
  • acute myocardial infarction
  • atrial arrhythmias
  • lipid lowering
  • NSTEMI
  • STEMI

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Footnotes

  • * A complete list of centres and investigators can be found in Cambou JP et al Arch Mal Coeur Vaiss 2007;100:524-534.

  • Funding The FAST-MI registry is a registry of the French Society of Cardiology, supported by unrestricted educational grants from Pfizer and Servier. Additional support was obtained from a research grant from the French Health Insurance system (Caisse Nationale d'Assurance Maladie).

  • Competing interests Dr Danchin has received fees for participating in symposia organised by, or served as a temporary consultant for Astra-Zeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Pfizer, Sanofi-Aventis, all of whom manufacture statins, and has been involved in a number of studies sponsored by these companies.

    Laurent Fauchier has received fees for participating in symposia organised by Astra-Zeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Sanofi-Aventis, all of whom manufacture statins, and has been involved in a number of studies sponsored by these companies.

    Eloi Marijon: None.

    Claude Barnay: None.

    Alain Furber has received fees for participating in symposia organised by Lilly, Sanofi-Aventis, Servier, and has been involved in a number of studies sponsored by these companies.

    Philippe Mabo: None.

    Paul Bernard: None.

    Jean-Jacques Blanc: None.

    Xavier Jouven: None.

    Jean-Yves Le Heuzey has received fees for participating in symposia organised by, or served as a temporary consultant for Sanofi-Aventis, Meda, Boehringer Ingelheim, Servier and Medtronic, and has been involved in a number of studies sponsored by these companies.

    Bernard Charbonnier: None.

    Jean Ferrières has obtained grants from Astra Zeneca, Boehringer Ingelheim, Pfizer and Sanofi-Aventis.

    Tabassome Simon reports receiving consulting fees from Bayer-Schering, Pfizer and Eli Lilly, Sanofi-Synthelabo; lecture fees from Bayer-Schering; and grant support from Pfizer and Servier.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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