Coronary artery disease
Comparison of Frequency of New-Onset Atrial Fibrillation or Flutter in Patients on Statins Versus Not on Statins Presenting With Suspected Acute Coronary Syndrome

https://doi.org/10.1016/j.amjcard.2007.03.034Get rights and content

The effect of statins on the incidence of new-onset atrial fibrillation (AF) in patients presenting with suspicion of acute coronary syndrome (ACS) is unknown. Our study population consisted of patients admitted to a tertiary care Veterans Administration hospital with suspicion of ACS between November 2001 and January 2006. All patients had an electrocardiogram on admission that was compared with a previous electrocardiogram to confirm new-onset AF or atrial flutter. Of 1,526 patients, 164 (10.8%) had new-onset AF and 601 (39.4%) were on a statin on admission. Patients with AF were significantly more likely to be older, Caucasian, have renal insufficiency and anemia, and less likely to be diabetic, on a statin or angiotensin-converting enzyme inhibitor on admission, or have chest pain as a presenting complaint. In univariate analysis, patients on statins were significantly less likely to have new-onset AF (odds ratio 0.40, 95% confidence interval 0.33 to 0.69, p <0.01). This relation persisted in the multivariate model (odds ratio 0.57, 95% confidence interval 0.39 to 0.83, p <0.01) after correcting for age, race, diabetes mellitus, chest pain, and use of angiotensin-converting enzyme inhibitor. In conclusion, patients presenting with suspicion of ACS were much less likely to have newonset AF if they were on a statin at time of presentation.

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Methods and Results

This study was approved by the institutional review board of the Veterans Administration Pittsburgh Healthcare System (Pittsburgh, Pennsylvania). The study population is from an ongoing registry of ACSs and is described elsewhere.2 Briefly, the population consists of patients admitted to monitored beds at the Veterans Administration hospital with suspected ACS/NSTEMI between January 2001 and April 2006.3 Clinical information including laboratory data and patient history were determined by chart

Discussion

Our study shows that use of statins appears to be associated with a significantly lower risk of new-onset AF in patients presenting with suspected ACS/NSTEMI, a finding consistent with previous observations that statins appear to play a beneficial role in the prevention of AF.4, 5, 6, 7 Although this correlation has been assessed in postsurgical patients, after cardioversion in lone AF, and in patients with left ventricular dysfunction, it has not been studied in patients presenting with an

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