European Heart Journal Advance Access originally published online on August 30, 2009
European Heart Journal
2009 30(19):2327-2336; doi:10.1093/eurheartj/ehp357
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Effects of rosuvastatin on atrial fibrillation occurrence: ancillary results of the GISSI-HF trial
1 GISSI-HF Coordinating Center, ANMCO Research Center, Via La Marmora, 34, 50121 Florence, Italy
2 Consorzio Mario Negri Sud, S Maria Imbaro, Italy
3 Istituto Mario Negri, Milano, Italy
4 Cardiology Unit, AO S Maria Angeli, Pordenone, Italy
5 Cardiology Unit, AO Brotzu-S Michele, Cagliari, Italy
6 Cardiology Unit, Ospedale Valdichiana Santa Margherita, Cortona, Italy
7 Cardiology Unit, Ospedale Ave Gratia Plena, San Felice a Cancello, Italy
8 GVM Hospitals of Care and Research, Cotignola, Italy
Received 23 July 2009; revised 5 August 2009; accepted 12 August 2009; online publish-ahead-of-print 30 August 2009.
* Corresponding author. Tel: +39 055 5101361, Fax: +39 055 5101310, Email: maggioni{at}anmco.it
See page 2302 for the commentary on this article (doi:10.1093/eurheartj/ehp362)
Aims: This ancillary analysis of the GISSI-HF database aims at assessing the effect of rosuvastatin on the occurrence of atrial fibrillation (AF) in patients with chronic heart failure (HF) who were not in AF at study entry.
Methods and results: GISSI-HF was a double-blind, placebo-controlled trial testing n-3 PUFA and rosuvastatin vs. corresponding placebos in patients with chronic HF. Atrial fibrillation occurrence was defined as the presence of AF in the electrocardiogram (ECG) performed at each visit during the trial or AF as a cause of worsening HF or hospital admission or as an event during hospitalization. Among the 3690 patients (80.7%) without AF on their baseline ECG, 15.0% developed AF during a median follow-up period of 3.7 years, 258 randomized to rosuvastatin (13.9%) vs. 294 allocated to placebo (16.0%). Although the difference was not significant at unadjusted analysis (P = 0.097) and multivariable analysis adjusting for clinical variables (P = 0.067), it became significant after adjustment for clinical variables and laboratory examinations (P = 0.039), and for clinical variables, laboratory examinations, and background therapies (P = 0.038).
Conclusion: This study shows that there is some evidence of a beneficial effect of rosuvastatin in terms of reduction of AF occurrence in patients with HF. Larger populations are needed to provide a definite answer to the question.
ClinicalTrials.gov Identifier: NCT00336336 [ClinicalTrials.gov]
Key Words: Atrial fibrillation • Heart failure • Rosuvastatin
The complete list of the GISSI-HF Investigators has been already published as Appendix of refs 19 and 21.
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