Statin Therapy Is Associated With a Lower Risk of Heart Failure in Patients With Atrial Fibrillation: A Population‐Based Study

Abstract

Background Whether statin use can reduce the risk of heart failure (HF) remains controversial. The present study evaluates the association between statin use and HF in patients with atrial fibrillation. Methods and Results Patients with newly diagnosed atrial fibrillation from 2010 to 2018 were included. An inverse probability of treatment weighting was used to balance baseline covariates between statin users (n=23 239) and statin nonusers (n=29 251). The primary outcome was incident HF. Cox proportional hazard models with competing risk regression were used to evaluate the risk of HF between statin users and nonusers. The median age of the cohort was 74.7 years, and 47.3% were women. Over a median follow‐up of 5.1 years, incident HF occurred in 3673 (15.8%) statin users and 5595 (19.1%) statin nonusers. Statin use was associated with a 19% lower risk of HF (adjusted subdistribution hazard ratio, 0.81 [95% CI, 0.78–0.85]). Restricted to the statin users, duration of statin use was measured during follow‐up; compared with short‐term use (3 months to <2 years), there was a stepwise reduction in the risk of incident HF among those with 2 to <4 years of statin use (subdistribution hazard ratio, 0.86 [95% CI, 0.84–0.88]), 4 to <6 years of statin use (subdistribution hazard ratio, 0.74 [95% CI, 0.72–0.76]), and ≥6 years of statin use (subdistribution hazard ratio, 0.71 [95% CI, 0.69–0.74]). Subgroup analysis showed consistent reductions in the risk of HF with statin use. Conclusions Statin use was associated with a decreased risk of incident HF in a duration‐dependent manner among patients with atrial fibrillation.

Statin Therapy in Ischemic Stroke Patients with Atrial Fibrillation: Efficacy and Safety Outcomes

“…Data from comprehensive national registries in Denmark, [21][22][23] South Korea 24 and China, 25 encompassing nearly 1.5 million patients, consistently reported the safety of statins in preventing cerebral hemorrhagic events, both as primary and secondary prophylaxis. 21 22,23,25 Furthermore, the findings suggest that both the duration and the dosage of statin therapy contribute to a protective effect against intracerebral hemorrhage.…”

“…Data from comprehensive national registries in Denmark, 21-23 South Korea 24 and China, 25 encompassing nearly 1.5 million patients, consistently reported the safety of statins in preventing cerebral hemorrhagic events, both as primary and secondary prophylaxis. 21 22,23,25 Furthermore, the findings suggest that both the duration and the dosage of statin therapy contribute to a protective effect against intracerebral hemorrhage. Patients with prolonged statin use and those on higher dosages had a lower risk of ICH, challenging the previously hypothesized biological mechanism linking LDL reduction to an increased bleeding risk.…”