Dosage of statin, cardiovascular comorbidities, and risk of atrial fibrillation: A nationwide population-based cohort study

Chen Ying Hung, Ching Heng Lin, Kuo Yang Wang, Jin Long Huang, Yu Cheng Hsieh, El Wui Loh, Tsuo Hung Lan, Pesus Chou, Chih Tai Ting, Tsu Juey Wu

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Statin has potential protective effects against atrial fibrillation. Clinically, there is a need to predict the atrial fibrillation protective effects in statin-treated patients. The purpose of this study was to investigate if cardiovascular co-morbidities or cumulative defined daily doses (cDDDs) of statin use could predict statin efficacy in atrial fibrillation prevention. Methods: Patients aged ≥50 years were identified from the Taiwan National Health Insurance Research Database. Medical records of 171,885 patients were used in this study, and 40,001 (23.3%) of the patients received statin therapy (≥28 cDDDs). Risk of new-onset atrial fibrillation in statin users and non-users (b28 cDDDs) was estimated. Results: During the 9-year follow-up period, 6049 patients experienced new-onset atrial fibrillation. Overall, statin therapy reduced the risk of atrial fibrillation by 28% (adjusted hazard ratio [HR] 0.72; 95% CI 0.68 to 0.77). There was a dose-response relationship between statin use and the risk of atrial fibrillation. The adjusted HRs for atrial fibrillation were 1.04, 0.85, and 0.50 when cDDDs ranged from 28 to 90, 91 to 365, and more than 365, respectively. Subgroup analysis showed that statin use was more beneficial in patients with higher CHADS2 and CHA2DS2VASc scores than those with a score of 0 (P value for interactionb0.001). The therapy provided no obvious beneficial effect in those with a CHADS2 score of 0, a CHA2DS2VASc score of 0, or cDDDs less than 91. Conclusions: Statin therapy reduces the risk of new-onset atrial fibrillation in a dose-dependent manner, and is beneficial in patients with cardiovascular co-morbidities.

Original languageEnglish
Pages (from-to)1131-1136
Number of pages6
JournalInternational Journal of Cardiology
Volume168
Issue number2
DOIs
Publication statusPublished - Sep 30 2013
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Atrial Fibrillation
Comorbidity
Cohort Studies
Population
Morbidity
National Health Programs
Therapeutics
Taiwan
Medical Records
Databases

Keywords

  • Atrial fibrillation
  • CHA2DS2VASc score
  • CHADS2 score
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dosage of statin, cardiovascular comorbidities, and risk of atrial fibrillation : A nationwide population-based cohort study. / Hung, Chen Ying; Lin, Ching Heng; Wang, Kuo Yang; Huang, Jin Long; Hsieh, Yu Cheng; Loh, El Wui; Lan, Tsuo Hung; Chou, Pesus; Ting, Chih Tai; Wu, Tsu Juey.

In: International Journal of Cardiology, Vol. 168, No. 2, 30.09.2013, p. 1131-1136.

Research output: Contribution to journalArticle

Hung, Chen Ying ; Lin, Ching Heng ; Wang, Kuo Yang ; Huang, Jin Long ; Hsieh, Yu Cheng ; Loh, El Wui ; Lan, Tsuo Hung ; Chou, Pesus ; Ting, Chih Tai ; Wu, Tsu Juey. / Dosage of statin, cardiovascular comorbidities, and risk of atrial fibrillation : A nationwide population-based cohort study. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 2. pp. 1131-1136.
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abstract = "Background: Statin has potential protective effects against atrial fibrillation. Clinically, there is a need to predict the atrial fibrillation protective effects in statin-treated patients. The purpose of this study was to investigate if cardiovascular co-morbidities or cumulative defined daily doses (cDDDs) of statin use could predict statin efficacy in atrial fibrillation prevention. Methods: Patients aged ≥50 years were identified from the Taiwan National Health Insurance Research Database. Medical records of 171,885 patients were used in this study, and 40,001 (23.3{\%}) of the patients received statin therapy (≥28 cDDDs). Risk of new-onset atrial fibrillation in statin users and non-users (b28 cDDDs) was estimated. Results: During the 9-year follow-up period, 6049 patients experienced new-onset atrial fibrillation. Overall, statin therapy reduced the risk of atrial fibrillation by 28{\%} (adjusted hazard ratio [HR] 0.72; 95{\%} CI 0.68 to 0.77). There was a dose-response relationship between statin use and the risk of atrial fibrillation. The adjusted HRs for atrial fibrillation were 1.04, 0.85, and 0.50 when cDDDs ranged from 28 to 90, 91 to 365, and more than 365, respectively. Subgroup analysis showed that statin use was more beneficial in patients with higher CHADS2 and CHA2DS2VASc scores than those with a score of 0 (P value for interactionb0.001). The therapy provided no obvious beneficial effect in those with a CHADS2 score of 0, a CHA2DS2VASc score of 0, or cDDDs less than 91. Conclusions: Statin therapy reduces the risk of new-onset atrial fibrillation in a dose-dependent manner, and is beneficial in patients with cardiovascular co-morbidities.",
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AU - Huang, Jin Long

AU - Hsieh, Yu Cheng

AU - Loh, El Wui

AU - Lan, Tsuo Hung

AU - Chou, Pesus

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AU - Wu, Tsu Juey

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