Six RCTs (n=3,557) were included in this review: three assessed statins in recurrent AF, two addressed post-operative AF and one studied new-onset AF in acute coronary syndrome.
The Jadad quality scores ranged from 2 to 5 out of a maximum of 5 points. Five trials studied atorvastatin and one studied pravastatin. The funnel plot was reported to be relatively symmetrical and unlikely to indicate major publication bias.
Statins were significantly associated with a decreased risk of AF recurrence compared with control treatments (OR 0.39, 95% CI: 0.18, 0.85, p=0.02). These benefits seemed stronger in the secondary prevention of AF, but were not statistically significant (OR 0.33, 95%CI: 0.10, 1.03, p=0.06), than for new-onset or post-operative AF where the benefit was not statistically significant. Atorvastatin produced a stronger effect when considered in isolation versus control (OR 0.30, 95% CI: 0.12, 0.78, p=0.01).
Random-effects models were used for all analyses. Sensitivity analyses did not significantly alter any of the results.