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European Heart Journal Advance Access originally published online on February 6, 2009
European Heart Journal 2009 30(7):827-833; doi:10.1093/eurheartj/ehp006
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Atorvastatin and persistent atrial fibrillation following cardioversion: a randomized placebo-controlled multicentre study

Henrik Almroth1,*, Niklas Höglund2, Kurt Boman3, Anders Englund1, Steen Jensen2, Björn Kjellman4, Per Tornvall5 and Mårten Rosenqvist4

1 Department of Cardiology, Örebro University Hospital, S-701 85 Örebro, Sweden
2 Department of Cardiology, Heart Centre, University Hospital, S-901 85 Umeå, Sweden
3 Department of Medicine, Skellefteå County Hospital, Umeå University, S-931 86 Umeå, Sweden
4 Department of Cardiology, Karolinska Institutet at Stockholm South Hospital, S-118 83 Stockholm, Sweden
5 Department of Cardiology, Karolinska University Hospital, S-171 76 Stockholm, Sweden

Received 21 May 2008; revised 26 November 2008; accepted 5 January 2009; online publish-ahead-of-print 6 February 2009.

* Corresponding author. Tel: +46 19 6021000, Fax: +46 19 6025438, Email: henrik.almroth{at}orebroll.se

Aims: To evaluate the effect of atorvastatin in achieving stable sinus rhythm (SR) 30 days after electrical cardioversion (CV) in patients with persistent atrial fibrillation (AF).

Methods and results: The study included 234 patients. The patients were randomized to treatment with atorvastatin 80 mg daily (n = 118) or placebo (n = 116) in a prospective, double-blinded fashion. Treatment was initiated 14 days before CV and was continued 30 days after CV. The two groups were well-balanced with respect to baseline characteristics. Mean age was 65 ± 10 years, 76% of the patients were male and 4% had ischaemic heart disease. Study medication was well-tolerated in all patients but one. Before primary endpoint 12 patients were excluded. In the atorvastatin group 99 patients (89%) converted to SR at electrical CV compared with 95 (86%) in the placebo group (P = 0.42). An intention-to-treat analysis with the available data, by randomization group, showed that 57 (51%) in the atorvastatin group and 47 (42%) in the placebo group were in SR 30 days after CV (OR 1.44, 95%CI 0.85–2.44, P = 0.18).

Conclusion: Atorvastatin was not statistically superior to placebo with regards to maintaining SR 30 days after CV in patients with persistent AF.

Key Words: Atrial fibrillation • Randomized • Cardioversion • Trials • Placebo-controlled • Lipids


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