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Statin use reduces risk of strokes in atrial fibrillation

The risk of different types of strokes is significantly lower in patients with atrial fibrillation who use who use one of the statin drugs.

Atrial fibrillation (AF) represents the most frequent cardiac arrhythmia. Data from 2017 suggests that globally, the condition affects 3.046 million people. Moreover, AF leads to a five-fold increase in stroke risk with up to 30% of these due to the arrhythmia.

In data presented at EHRA 2023, the risk of strokes was lower in AF patients using statins within a year of their diagnosis. While it is already known that statin use in AF reduces the risk of all-cause mortality. But whether the drugs reduce stroke risk is uncertain.

However, some data suggests that high intensity statins may reduce cerebral events in patients with acute ischaemic stroke and AF.

In the study at EHRA 2023, researchers from Hong Kong, examined a cohort of newly diagnosed AF patients. Individuals were either statin or non-statin users in relation to their AF diagnosis. For instance, a statin user was taking the drug before their AF diagnosis.

The primary outcome was any form of stroke, e.g., ischaemic, systemic embolism, haemorrhagic or a transient ischaemic attack (TIA).

Risk of strokes in AF patients using statins

A total of 51,472 AF patients of whom, 11,866 were receiving a statin had analysable data.

During a median follow-up of 5.1 years, among statin users, the ischaemic stroke and systemic embolism risk was 17% lower than non-users (Hazard ratio, HR = 083, 95% CI 0.78 – 0.89). The risk of a haemorrhagic stroke (HS) was 7% lower (HR = 0.93) and the TIA risk 15% lower (HR = 0.85).

Use of statins for 6 years would reduce the risk of an ischaemic stroke or system embolism by 43% compared to use for less than 2 years (HR = 0.57). This risk was also lower for the other cerebral events.

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