The Effect Of Statins On The Prevention And Therapy Of Atrial Fibrillation : A META Analysis Of Randomized Controlled Trials

Objective To investigate the effect of statins on the prevention and therapy of atrial fibrillation.Method We searched the electronic databases from inception to April 14 2011 for public published randomized controlled trials that assessed the effect of statins therapy on atrial fibrillation.Before the randomized controlled trials were included in this meta-analysis,we evaluated the quality of the trails by the title and abstract of the literature.If the clinical RCTs conforms to the inclusive criteria without the exclusive criteria items,they would be enrolled in this meta-analysis.And then we conducted the meta-analysis of the data collected from the included studies with the soft of review manager 5.1.Results After the searching of electronic databases and the evaluating of the RCTs according to the inclusive criteria and exclusive criteria of this meta-analysis,thirteen RCTs with 4902 subjects were included.There were seven high quality studies with jadad scores of three to five points and six low quality studies with jadad scores of one to two points of the thirteen RCTs which were included in this meta anlysis finally. As the result of the test for heterogeneity showed significant heterogeneity of the RCTs,we chosen the fixed effect model to analyze the data.The meta-analysis of RCTs showed significant effect of statins on the prevention and therapy of atrial fibrillation of patients who just underwent the procedure of cardiac surgery(RR=0.53,95%CI(0.41,0.57),P<0.00001) and also for the patients without the history of cardiac surgery(RR=0.62 ,95%CI(0.47,0.81),P=0.0006);The result of meta-analysis of included RCTs also showed significant effect of statins on the prevention of new onset atrial fibrillation(RR=0.58,95%CI(0.42,0.80),P=0.0009).The result also showed significant effect of statins on the prevention and therapy of atrial fibrillation of patients who was administered statins for short duration(three weeks to one year)(RR=0.55,95%CI(0.40,0.75),P=0.0002) and also for the patients with long-term therapy(more than one year) of statins (RR=0.63,95%CI(0.46,0.84),P=0.002);What is more,the result of this meta-analysis also showed positive effect of statins on the reccurance and progress of atrial fibrillation(RR=0.56,95%CI(0.38,0.81),P=0.002). However,sensitivity analysis showed that the result of statins on the reccurance and progress of atrial fibrillation was unreliable,which could be inversed by excluding the low quality randomized controlled trials.Therefore the effect of statins on the reccurance and progress of atrial fibrillation was uncertain ,which need more large scale RCTs to be detected.Conclusion This meta-analysis of RCTs showed significant effect of statins on the prevention and therapy of atrial fibrillation of patients regardless of whether they had ever had the history of cardiac surgery,and also showed significant effect of statins on the prevention of new onset atrial fibrillation.What's more,the meta analysis demonstrated significant effect of statins on the prevention and therapy of atrial fibrillation of patients with short-term therapy(three weeks to one year) or long-term therapy(more than one year) of statins.Considering the result of sensitivity analysis,however,the effect of statins on the reccurance and progress of atrial fibrillation was uncertain, which need more large scale RCTs to be detected.