PS-C02-8: ROLE OF STATIN THERAPY IN HYPERTENSION, PLEIOTROPIC EFFECT IN REDUCING NEW-ONSET AF AND ISCHEMIC STROKE

Abstract

Introduction: Hypertension is considered the most important risk factor for stroke in the general population, is the most common comorbidity in patients with atrial fibrillation (AF), and is prevalent in approximately 80 to 90% of subjects with AF enrolled in recent clinical trials. Statin drugs have potent anti inflammatory and antioxidant effects that have the potential to prevent AF. Patients who had ischemic stroke complications due to episodes of AF are usually asymptomatic, thus primary prevention of AF in hypertensive patients is very important. Objectives: To determine the effectiveness of statin in reducing the incidence of new onset AF and ischemic stroke complications in hypertensive patients. Methods: We included 180 subjects in this retrospective cohort study using medical records at Sanglah General Hospital from 2018 to 2020. Subjects were divided into hypertensive subjects who were treated with a statin and hypertensive subjects who were not given statins, and we tracked the incidence of new onset AF. Pearson chi square test was used to determine the association of baseline characteristics, comorbidities, and medications, including statin, on the outcome of new onset AF, ischemic stroke, and side effects of statin. The progression of new onset AF between groups was also compared with the Kaplan Meier curve. Results: Our subjects who used statin were 39.4%, the mean age for all was 51.51+12.31 with 28,3% new onset AF, 7,2% ischemic stroke, and 2.2% all cause death. Statin in hypertensive patients significantly reduced the incidence of new onset AF (PR 0.174; 95%CI 0.079–0.38; P < 0.001) with a longer AF free period (19.16 + 2.57 vs 13.68 + 0.67 months; 95%CI 5.01–5.84; P = 0.014) and ischemic stroke free period (23.72 + 0.71 vs 16.57 + 1.06 month; 95%CI 5.01–5.84; P = 0.003), without any significant relationship with the adverse effect of statin. The incidence of AF was significantly high in hypertensive subjects with comorbid heart failure (HF) however, the AF free period remains longer if hypertensive patients with HF are given statin (19.16 + 2.57 vs 13.68 + 0.67 month; 95%CI 5.01–5.84; P = 0.014). Conclusion: Statin administration has the potential to be an effective treatment for primary prevention of the incidence of new onset AF and ischemic stroke in hypertensive patients without significant side effects.