Effects of Pitavastatin on Cardiac Structure and Function and on Prevention of Atrial Fibrillation in Elderly Hypertensive Patients: A Prospective Study of 2-Years’ Follow-up

• Published in: Circulation Journal 2012, Vol.76(12), pp.2755-2762
• Main Authors: Warita, Shunichiro, Kawasaki, Masanori, Tanaka, Ryuhei, Ono, Koji, Kojima, Tai, Hirose, Takeshi, Iwama, Makoto, Watanabe, Takatomo, Nishigaki, Kazuhiko, Takemura, Genzou, Noda, Toshiyuki, Watanabe, Sachiro, Minatoguchi, Shinya
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - mortality; Atrial Fibrillation - physiopathology; Atrial Fibrillation - prevention & control; Atrial function; Atrial Function, Left - drug effects; Chi-Square Distribution; Disease-Free Survival; Dyslipidemias - diagnosis; Dyslipidemias - drug therapy; Dyslipidemias - mortality; Dyslipidemias - physiopathology; Electrocardiography; Female; Follow-Up Studies; Heart Atria - diagnostic imaging; Heart Atria - drug effects; Heart Atria - physiopathology; Heart Ventricles - diagnostic imaging; Heart Ventricles - drug effects; Heart Ventricles - physiopathology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - mortality; Hypertension - physiopathology; Hypertrophy, Left Ventricular - drug therapy; Hypertrophy, Left Ventricular - physiopathology; Japan - epidemiology; Kaplan-Meier Estimate; Male; Multivariate Analysis; Proportional Hazards Models; Prospective Studies; Quinolines - therapeutic use; Statins; Stroke Volume - drug effects; Time Factors; Treatment Outcome; Ultrasonography; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Dysfunction, Left - prevention & control; Ventricular Function, Left - drug effects
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-12-0722

Background: The aim of this prospective study was to determine whether statin therapy (pitavastatin) has a beneficial effect on the prevention of new-onset atrial fibrillation (AF) in elderly patients with hypertension (HTN) and to evaluate the relationships among statin treatment, the development of AF, and left atrial (LA) and ventricular (LV) structure and function. Methods and Results: We enrolled eligible elderly patients (≥65 years old) with HTN and LV hypertrophy until the number of patients reached 110 in both groups. The 110 patients with HTN who needed statin therapy (HTN with statin group) were started on pitavastatin (1–2mg/day), and both groups continued with appropriate medication for HTN. LV and LA structure and function were examined by conventional and speckle-tracking echocardiography at baseline and after 1 year. LA volume and function in the HTN with statin group improved more than in the HTN without statin group. There was a significant difference in survival free of new-onset AF in the patients with and without statin therapy during the 2-year follow-up (hazard ratio: 0.32, P=0.027). Conclusions: Pitavastatin had a beneficial effect on LV diastolic function and LA structure and function in elderly patients with HTN. Pitavastatin treatment may be associated with a lower incidence of new-onset AF.  (Circ J 2012; 76: 2755–2762)