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Could statins help lower stroke risk in people with atrial fibrillation? Image credit: Fahroni/Getty Images
  • Atrial fibrillation affects over 40 million people worldwide and increases the risk of stroke.
  • While anticoagulant medication is commonly used to prevent further strokes, it does not eliminate the risk entirely.
  • Now, a new study involving over 50,000 patients with atrial fibrillation has found that the use of statins is associated with a reduced risk of stroke and temporary loss of blood flow to the brain.
  • The results of this study were presented at the EHRA Congress 2023 conference held in Barcelona, Spain, organized by the European Society of Cardiology.

Patients with atrial fibrillation (AFib), a heart rhythm disorder, are five times more likely to experience a stroke compared to those without the condition.

Although anticoagulant drugs are commonly recommended to prevent stroke in patients with AFib, they do not completely remove the risk.

Statins, a commonly used medication used to reduce blood cholesterol and the likelihood of heart attack and stroke, are frequently prescribed for patients with AFib. However, their effectiveness in preventing strokes in individuals with this condition has remained unclear.

In the new study, the researchers aimed to assess the correlation between the use of statins and the occurrence of stroke and transient ischemic attack in patients diagnosed with AFib.

To identify all individuals who were newly diagnosed with atrial fibrillation between 2010 and 2018, the researchers accessed data from the Hong Kong Clinical Data Analysis and Reporting System.

The participants were divided into two categories: statin users and non-users.

Statin users were defined as individuals who had been taking the medication for at least 90 consecutive days within one year of their AFib diagnosis.

The primary outcomes of the study that the researchers looked to identify were stroke, blood clots that can travel through the body, and temporary loss of blood flow to the brain.

The researchers followed up with the patients until they experienced any of these events, passed away, or until the study ended on October 31, 2022.

The research looked at data from over 51,000 people who had recently received an AFib diagnosis.

The study found that those taking statins had a 17% lower risk of having a stroke or a blood clot that travels through the body, a 7% lower risk of having a bleeding stroke, and a 15% lower risk of having a temporary loss of blood flow to the brain compared to those not taking statins.

The researchers found that using statins for a long time provided more protection against stroke and similar problems compared to using them for a short period.

For patients who used statins for 6 years or more, their risk of stroke or blood clots that travel through the body was 43% lower compared to those who took the medication for only 3 months to 2 years.

They also had a 44% lower chance of having a bleeding stroke and a 42% lower risk of temporary loss of blood flow to the brain.

Dr. Nikhil P. Warrier, board-certified cardiac electrophysiologist and medical director of electrophysiology at Memorial Care Heart & Vascular Institute at Orange Coast Medical Center, not involved in this research, highlighted to Medical News Today that previous research had been published on this topic.

When commenting on the new study, Dr. Warrier noted that “these data add more support to use statins in AFib patients to decrease risk of stroke and TIA [transient ischemic attack] events which can be one of the most catastrophic outcomes associated with AFib.”

“AFib is the most common arrhythmia that we deal with as electrophysiologists. Anything that we can do to minimize the cardiovascular and cerebrovascular sequelae associated with AFib is a welcome finding. Patients should discuss these data with their cardiologist and see if statin therapy is indicated for them.”

– Dr. Nikhil P. Warrier

Dr. Sarina van der Zee, a board-certified cardiac electrophysiologist and cardiologist at Providence Saint John’s Health Center, also not involved in the study, told MNT that “this study of more than 50,000 patients shows a significant link between statin use and reduced stroke risk in patients with atrial fibrillation.”

“Lowering cholesterol and treating atrial fibrillation have been thought of as separate issues, but this shows a link between the two. Treating one could help the other,” Dr. van der Zee explained.

Nancy Mitchell, a registered nurse and contributing writer at the Assisted Living Center, also not involved in the research, noted that “as a ‘region-wide study,’ the results may provide insight into the benefits of statin use for Eastern-based individuals.”

“However, we still need to acknowledge that the diet culture varies from that of the Western world. When it comes to heart health, we can’t ignore diet as a contributing factor to the state of one’s health. So there’s still some limit as to who will most likely see similar results from the population study.”

“It merits further investigation on the effects of statins on the heath of AFib patients from other regions. With the United States having one of the leading mortality rates due to heart disease, it would be interesting to see how a similar investigation would fare out with persons from that region.”

– Nancy Mitchell