TY - JOUR
T1 - Statin Therapy Is Associated With a Lower Risk of Heart Failure in Patients With Atrial Fibrillation: A Population-Based Study
AU - Huang, Jia-Yi
AU - Chan, Yap-Hang
AU - Tse, Yi-Kei
AU - Yu, Si-Yeung
AU - Li, Hang-Long
AU - Chen, Cong
AU - Zhao, Chun-Ting
AU - Liu, Ming-Ya
AU - Wu, Mei-Zhen
AU - Ren, Qing-Wen
AU - Leung, Ka-Lam
AU - Hung, Denise
AU - Li, Xin-Li
AU - Tse, Hung-Fat
AU - Lip, Gregory Y. H.
AU - Yiu, Kai-Hang
PY - 2023/12/5
Y1 - 2023/12/5
N2 - 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.
AB - 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.
KW - Aged
KW - Atrial Fibrillation/diagnosis
KW - Female
KW - Heart Failure/epidemiology
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
KW - Male
KW - Probability
KW - Risk
KW - heart failure
KW - population-based cohort study
KW - low-density lipoprotein cholesterol
KW - atrial fibrillation
KW - statins
UR - http://www.scopus.com/inward/record.url?scp=85179005136&partnerID=8YFLogxK
U2 - 10.1161/JAHA.123.032378
DO - 10.1161/JAHA.123.032378
M3 - Journal article
C2 - 38014688
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 23
M1 - e032378
ER -