他汀类药物可以预防透析患者心房颤动(以下简称房颤)吗?近期台湾学者针对上述问题开展了一项研究。研究者们纳入了100%接受透析的患者，年龄在18岁及以上且无心血管事件病史。最后有113191例透析患者入组。利用倾向评分(PS)匹配法和Coxb比例风险回归模型评估他汀使用者和非使用者的房颤事件危险比。

        结果显示，与对照组相比，他汀治疗组新发房颤发生率明显较低(1.1% vs. 3.8%, P < 0.001)。基于PS筛选过程识别了2146例接受他汀治疗者和2146例未接受他汀治疗者。与对照组相比，他汀治疗组进展为房颤的发生率持续较低(2.4% vs. 4.9%, P < 0.001)。

        PS匹配法和Coxb比例风险回归模型分析显示，他汀对房颤进展的保护作用呈剂量反应模式。这种保护性作用更常见于较年轻的、女性、高脂血症、冠状动脉疾病和外周动脉疾病的受试者，以及那些未服用血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂受试者。

        该研究表明，他汀类药物治疗与透析患者新发房颤风险较低有关。

        相关论文近期发表于《国际心脏病学杂志》(International Journal of Cardiology)。

        参考文献：Li-Ting Ho, et al. International Journal of Cardiology . December 15, 2015Volume 201, Pages 538–543.DOI: http://dx.doi.org/10.1016/j.ijcard.2015.01.040

Statin therapy lowers the risk of new-onset atrial fibrillation in patients with end-stage renal disease
Li-Ting Ho1
,
Lian-Yu Lin1
,
Yao-Hsu Yang
,
Cho-Kai Wu
,
Jyh-Ming Jimmy Juang
,
Yi-Chih Wang
,
Chia-Ti Tsai
,
Ling-Ping Lai
,
Juey-Jen Hwang
,
Fu-Tien Chiang
,
Jiunn-Lee Lin 
,
Pau-Chung Chen 
1These authors contributed equally to the work.

DOI: http://dx.doi.org/10.1016/j.ijcard.2015.01.040
Abstract
Objectives
The objective is to assess the effectiveness of statin use to prevent atrial fibrillation (AF) in dialysis patients.
Methods
We used a database from the Registry for Catastrophic Illness from the National Health Research Institute (NHRI), which encompasses almost 100% of the patients receiving dialysis started from 1997 to 2008 in Taiwan. All dialysis patients aged 18 or older without history of cardiovascular events in 1997 and 1998 were incorporated. Finally, 113,191 dialysis patients were enrolled. We used propensity score (PS) matching method and Cox's proportional hazard regression models to estimate hazard ratios for AF events for statin users vs. nonusers.
Results
In statin group, the incidence of developing new AF was significantly lower than that in control group (1.1% vs. 3.8%, P < 0.001). The PS-based selection process identified 2146 patients receiving statins and 2146 who did not receive statins. The incidence of developing AF remained lower in statin group than that in control group (2.4% vs. 4.9%, P < 0.001). After PS matching, Cox's proportional hazard regression analyses showed that there was a protective effect of developing AF in a dose-responsive manner. The protective effect was more obvious in subjects with younger age, female gender, hyperlipidemia, coronary artery disease and peripheral artery disease and in subjects without taking angiotensin converting enzyme inhibitor and angiotensin receptor blocker.
Conclusion
Our analyses showed that statin therapy was associated with lower risk of newly diagnosed AF in patients with dialysis.