Beneficial effects of statin therapy for prevention of atrial fibrillation following DDDR pacemaker implantation
Beneficial effects of statin therapy for prevention of atrial fibrillation following DDDR pacemaker implantation
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DOI：
10.1093/eurheartj/ehn192
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发表时间：
2008-08-01
影响因子：
39.3
通讯作者：
Wyse, D. George
中科院分区：
文献类型：
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作者：
Gillis, Anne M.;Morck, Margaret;Wyse, D. George
研究目的：有资料表明，心房起搏、他汀类药物、血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂可预防部分患者的房性心动过速/房颤（AT/AF）。在185例连续阵发性AF患者中检查了双腔起搏器植入后AT/AF复发的临床预测因素。在每次随访访视时通过询问起搏器检索至首次AT/AF复发的时间和AT/AF负荷（h/天）。157例（85%）患者植入起搏器后AT/AF复发。随访1年时，与未接受他汀类药物治疗的患者（25%，卡方= 12.31，P = 0.0004）相比，未复发的患者更可能接受他汀类药物治疗（54%）。在多变量logistic回归模型中，他汀类药物治疗是AT/AF复发的唯一显著预测因素（校正比值比0.33，95%置信区间0.14-0.74，P = 0.007）。他汀类药物治疗组AT/AF负荷（中位数0.10 h/d）显著低于非他汀类药物治疗组（中位数0.39 h/d，P = 0.0059）。随着时间的推移，进展为永久性AF的风险仍然较低。他汀类药物治疗与AT/AF抑制显著相关。
Aims Data suggest that atrial pacing, statins, angiotensin-converting enzyme-inhibitors and angiotensin receptor blocking drugs prevent atrial tachycardia/atrial fibrillation (AT/AF) in some patients. The clinical predictors of AT/AF recurrence following dual-chamber pacemaker insertion were examined in 185 consecutive patients with paroxysmal AF.Methods and results Predictors of AT/AF recurrence were evaluated in this observational cohort study. The time to first AT/AF recurrence and AT/AF burden (h/day) was retrieved at each follow-up visit by interrogating the pacemaker. AT/AF recurred following pacemaker implantation in 157 (85%) patients. At 1 year of follow-up, patients without recurrence were more likely to be on statin therapy (54%) when compared with patients without statin therapy (25%, chi = 12.31, P = 0.0004). Statin therapy was the only significant predictor of AT/AF recurrence in a multivariate logistic regression model (adjusted odds ratio 0.33, 95% confidence interval 0.14-0.74, P = 0.007). AT/AF burden was significantly lower in the group on statin therapy (median 0.10 h/day) when compared with the group not on statin therapy (median 0.39 h/day, P = 0.0059).Conclusion AT/AF recurs frequently following pacemaker implantation in patients with sinus node disease. The progression to permanent AF remains low over time. Statin therapy was significantly associated with AT/AF suppression.