Statin use tied to lower stroke risk in patients with AF

Among patients with atrial fibrillation (AF), statin use was associated with a significantly lower risk of stroke or transient ischaemic attack (TIA) compared with non-use, according to a study presented at EHRA 2023.

“AF is the most common heart rhythm disorder, affecting >40 million people worldwide. Patients with the condition have a five times greater risk of stroke than their peers. Anticoagulant medication is recommended to prevent strokes in those with AF but does not completely eliminate the risk,” said lead author Miss Jiayi Huang from the University of Hong Kong, Hong Kong.

“Statin therapy is widely prescribed to lower blood cholesterol and reduce likelihood of heart attack and stroke. However, the benefit of statins for stroke prevention in patients with AF has been unclear,” she noted.

Hence, the researchers conducted a population-based study involving 51,472 patients (median age 74.9 years, 47.7 percent female) who were newly diagnosed with AF to evaluate the association between statin use and the incidence of stroke and TIA. A total of 11,866 patients were identified as statin users, for ≥19 consecutive days during the year after being diagnosed with AF, and compared with 39,606 nonusers. The primary endpoint was the composite of ischaemic stroke and systemic embolism, haemorrhagic stroke, and TIA. [EHRA 2023]

At a median follow-up of 5.1 years, statin users showed a significantly lower risk of ischaemic stroke or systemic embolism compared with nonusers (hazard ratio [HR], 0.83; p<0.01).

Similarly, the risk of haemorrhagic stroke and TIA was significantly reduced by 7 percent and 15 percent, respectively, among those treated with statin compared with those who were not (HRs, 0.93 and 0.87, respectively; p<0.01 for both).

Furthermore, statin use of ≥6 years was associated with a greater protective effect, effectively reducing the risk of the composite outcome compared with shorter-term use of 3 months to <2 years (HRs, 0.57, 0.56, and 0.58 for ischaemic stroke or systemic embolism, haemorrhagic stroke, and TIA, respectively). “These associations were consistent regardless of whether or not the patient uses anticoagulant medications and the type of anticoagulants,” noted Huang.

“Overall, the data support the use of statins to prevent stroke and TIA in patients with new-onset AF,” Huang said.