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Objective <p>Whether statins, as upstream therapy for atrial fibrillation (AF), can reduce the incidence of AF in elderly individuals remains unclear. This study aimed to examine whether statin use is linked to a lower risk of incident AF in older adults from Shanghai, China. To provide important implications for optimizing the prevention and management strategies of AF in the elderly.</p> Methods <p>Data for this retrospective cohort study were collected from a community health service center in Shanghai. Individuals had no history of AF in 2018 and before were included, and new cases of AF were documented in 2019, 2020, and 2021. A Poisson generalized linear model was used to evaluate the relationship between statin treatment and AF incidence. Both standard covariate adjustment and propensity score matching (PSM) to control for confounding factors. To evaluate the risk factors for new-onset AF among the elderly, univariate logistic analysis was conducted. Variables with statistical significance in univariate analysis (<i>p</i> &lt; 0.05), such as sex, age, SBP, BMI, WHR, Scr and HbA1c were selected as covariates for inclusion in the multivariable logistic regression model.</p> Results <p>Out of the 5675 individuals in the study group (43.5% male; median age of 68&#xa0;years), 456 participants (8.0%) received statin treatment. The propensity score unmatched and matched cohorts of 453 participants (stain users and nou-users) were evaluated, in each group. There was no reduction in AF incidence with statin use (95%CI, 0.948 to 1.018) in the unmatched cohort and in the matched cohort (95%CI, 0.459 to 1.512). The multivariate regression analysis results showed that age, SBP, BMI, HbA1c and Scr were factors independently linked to the occurrence of new-onset AF. Despite extensive analysis, our study did not find evidence that statin use reduces the risk of new-onset AF in this population.</p> Conclusion <p>For older people, taking statins did not reduce risk of new on-set AF. Independent predictors of AF onset including age, SBP, BMI, HbA1c and Scr. This is a retrospective cohort study, making it difficult to completely control for all confounding factors, and the short follow-up period may have resulted in insufficient statistical power to detect a meaningful effect of statins on atrial fibrillation. Future studies may use randomized controlled studies to explore the effects of different types and doses of statins on new-onset atrial fibrillation in older adults.</p>

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Association between statin use and the risk of atrial fibrillation in community-dwelling older people in Shanghai, China: a propensity score-matched study

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  • 发表日期：

    2025年9月25日

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  • Tiantian Deng,
  • Fei Sheng,
  • Ziqiang Zhang

摘要

Objective

Whether statins, as upstream therapy for atrial fibrillation (AF), can reduce the incidence of AF in elderly individuals remains unclear. This study aimed to examine whether statin use is linked to a lower risk of incident AF in older adults from Shanghai, China. To provide important implications for optimizing the prevention and management strategies of AF in the elderly.

Methods

Data for this retrospective cohort study were collected from a community health service center in Shanghai. Individuals had no history of AF in 2018 and before were included, and new cases of AF were documented in 2019, 2020, and 2021. A Poisson generalized linear model was used to evaluate the relationship between statin treatment and AF incidence. Both standard covariate adjustment and propensity score matching (PSM) to control for confounding factors. To evaluate the risk factors for new-onset AF among the elderly, univariate logistic analysis was conducted. Variables with statistical significance in univariate analysis (p < 0.05), such as sex, age, SBP, BMI, WHR, Scr and HbA1c were selected as covariates for inclusion in the multivariable logistic regression model.

Results

Out of the 5675 individuals in the study group (43.5% male; median age of 68 years), 456 participants (8.0%) received statin treatment. The propensity score unmatched and matched cohorts of 453 participants (stain users and nou-users) were evaluated, in each group. There was no reduction in AF incidence with statin use (95%CI, 0.948 to 1.018) in the unmatched cohort and in the matched cohort (95%CI, 0.459 to 1.512). The multivariate regression analysis results showed that age, SBP, BMI, HbA1c and Scr were factors independently linked to the occurrence of new-onset AF. Despite extensive analysis, our study did not find evidence that statin use reduces the risk of new-onset AF in this population.

Conclusion

For older people, taking statins did not reduce risk of new on-set AF. Independent predictors of AF onset including age, SBP, BMI, HbA1c and Scr. This is a retrospective cohort study, making it difficult to completely control for all confounding factors, and the short follow-up period may have resulted in insufficient statistical power to detect a meaningful effect of statins on atrial fibrillation. Future studies may use randomized controlled studies to explore the effects of different types and doses of statins on new-onset atrial fibrillation in older adults.