Early statin therapy may reduce early AF risk post-MI
MedWire News: Starting statin therapy within 48 hours of admission for acute myocardial infarction (AMI) may reduce the risk for developing atrial fibrillation (AF) during hospital stay, French researchers report.
Nicolas Danchin (Université Paris Descartes) and colleagues say that this effect of statin therapy is further amplified when the drug is administered at higher therapeutic doses.
Using data from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI), Danchin et al assessed the development of AF during initial hospital stay (ie, until death or discharge to home or rehabilitation center) among 3396 patients admitted with AMI.
All patients were in sinus rhythm on admission and received statin therapy within 48 hours (n=2551, early therapy) or more than 48 hours after admission (n=845, non-early therapy).
Of all patients receiving early statin therapy, 406 received a high dose (atorvastatin 80 mg or rosuvastatin 40 mg daily), 510 received an intermediate dose (atorvastatin 40 mg or rosuvastatin 20 mg daily), and the remaining 1635 patients received a dose deemed by the researchers to be of a conventional size.
The findings, published in the journal Heart, show that fewer patients with early stain therapy developed AF while in hospital than those with non-early statin therapy, at a rate of 3.9% versus 7.0%, respectively (p<0.001).
Multivariate analysis, including propensity for early statin therapy, showed that early treatment with statins reduced acute AF risk by 36% compared with non-early treatment (p=0.017).
A dose-related effect was also observed, with early statin therapy at conventional, intermediate, and high doses associated with 28%, 48%, and 60% reductions in AF risk, respectively, although the authors note that the confidence intervals between doses overlapped .
Danchin and team conclude that in light of the known poor long-term outcome associated with the development of AF during the early stages of AMI, and the added bleeding risk associated with concurrent AF and AMI antiplatelet-anticoagulation therapy, their findings should provide "additional incentive" for the implementation of early statin therapy in patients with acute coronary syndromes.
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By Lauretta Ihonor