Twenty RCTs (23,577 patients; range 40 to 8,582) were included in the review. Of the 20 trials, two scored 1 point on Jadad, four scored 2 points, five scored 3 points, three scored 4 points and six scored 5 points. Duration of follow-up ranged from seven to 37 days in post-operative patients, and one month to 3.7 years in patients with recurrent atrial fibrillation.
Overall (20 RCTs), statins significantly reduced the risk of atrial fibrillation compared with control (OR 0.49, 95% CI 0.37 to 0.65; Ι²=69%).
When analysed by statin, there was a significant reduction in the risk of atrial fibrillation with atorvastatin (OR 0.38, 95% CI 0.24 to 0.61; 11 RCTs; Ι²=71%) and simvastatin (OR 0.12, 95% CI 0.04 to 0.40; two RCTs; Ι²=0), but not pravastatin (four RCTs) or rosuvastatin (three RCTs).
When analysed by population, there was a significant reduction in the risk of atrial fibrillation in patients with prior atrial fibrillation (OR 0.34, 95% CI 0.18 to 0.64; eight RCTs; Ι²=74%) and no prior atrial fibrillation (OR 0.54, 95% CI 0.40 to 0.74; 12 RCTs; Ι²=47%), but not in the largest RCT with a mixed population.
Results of post hoc analyses were also reported.
The authors reported that publication bias may have been present for the population with no prior atrial fibrillation.