Article Text
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.