Li-Ting Ho1, Lian-Yu Lin1, Yao-Hsu Yang2, Cho-Kai Wu3, Jyh-Ming Jimmy Juang1, Yi-Chih Wang1, Chia-Ti Tsai1, Ling-Ping Lai1, Juey-Jen Hwang1, Fu-Tien Chiang4, Jiunn-Lee Lin5, Pau-Chung Chen6. 1. Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. 2. Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital Chia-Yi, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan. 3. Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. 4. Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan. 5. Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. Electronic address: jiunnlee@ntu.edu.tw. 6. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan. Electronic address: pchen@ntu.edu.tw.
Abstract
OBJECTIVES: The objective is to assess the effectiveness of statin use to prevent atrial fibrillation (AF) in dialysis patients. METHODS: We used a database from the Registry for Catastrophic Illness from the National Health Research Institute (NHRI), which encompasses almost 100% of the patients receiving dialysis started from 1997 to 2008 in Taiwan. All dialysis patients aged 18 or older without history of cardiovascular events in 1997 and 1998 were incorporated. Finally, 113,191 dialysis patients were enrolled. We used propensity score (PS) matching method and Cox's proportional hazard regression models to estimate hazard ratios for AF events for statin users vs. nonusers. RESULTS: In statin group, the incidence of developing new AF was significantly lower than that in control group (1.1% vs. 3.8%, P<0.001). The PS-based selection process identified 2146 patients receiving statins and 2146 who did not receive statins. The incidence of developing AF remained lower in statin group than that in control group (2.4% vs. 4.9%, P<0.001). After PS matching, Cox's proportional hazard regression analyses showed that there was a protective effect of developing AF in a dose-responsive manner. The protective effect was more obvious in subjects with younger age, female gender, hyperlipidemia, coronary artery disease and peripheral artery disease and in subjects without taking angiotensin converting enzyme inhibitor and angiotensin receptor blocker. CONCLUSION: Our analyses showed that statin therapy was associated with lower risk of newly diagnosed AF in patients with dialysis.
OBJECTIVES: The objective is to assess the effectiveness of statin use to prevent atrial fibrillation (AF) in dialysis patients. METHODS: We used a database from the Registry for Catastrophic Illness from the National Health Research Institute (NHRI), which encompasses almost 100% of the patients receiving dialysis started from 1997 to 2008 in Taiwan. All dialysis patients aged 18 or older without history of cardiovascular events in 1997 and 1998 were incorporated. Finally, 113,191 dialysis patients were enrolled. We used propensity score (PS) matching method and Cox's proportional hazard regression models to estimate hazard ratios for AF events for statin users vs. nonusers. RESULTS: In statin group, the incidence of developing new AF was significantly lower than that in control group (1.1% vs. 3.8%, P<0.001). The PS-based selection process identified 2146 patients receiving statins and 2146 who did not receive statins. The incidence of developing AF remained lower in statin group than that in control group (2.4% vs. 4.9%, P<0.001). After PS matching, Cox's proportional hazard regression analyses showed that there was a protective effect of developing AF in a dose-responsive manner. The protective effect was more obvious in subjects with younger age, female gender, hyperlipidemia, coronary artery disease and peripheral artery disease and in subjects without taking angiotensin converting enzyme inhibitor and angiotensin receptor blocker. CONCLUSION: Our analyses showed that statin therapy was associated with lower risk of newly diagnosed AF in patients with dialysis.