Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study

Casper N Bang; Anders M Greve; Kurt Boman; Kenneth Egstrup; Christa Gohlke-Baerwolf; Lars Køber; Christoph A Nienaber; Simon Ray; Anne B Rossebø; Kristian Wachtell

doi:10.1016/j.ahj.2012.01.026

Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study

Casper N Bang, Anders M Greve, Kurt Boman, Kenneth Egstrup, Christa Gohlke-Baerwolf, Lars Køber, Christoph A Nienaber, Simon Ray, Anne B Rossebø, Kristian Wachtell

9 Citationer (Scopus)

Abstract

Background: Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS). Methods: Asymptomatic patients with mild-to-moderate AS (n = 1,421) were randomized (1:1) to double-blind simvastatin 40 mg and ezetimibe 10 mg combination or placebo and followed up for a mean of 4.3 years. The primary end point was the time to new-onset AF adjudicated by 12-lead electrocardiogram at a core laboratory reading center. Secondary outcomes were the correlates of new-onset AF with nonfatal nonhemorrhagic stroke and a combined end point of AS-related events. Results: During the course of the study, new-onset AF was detected in 85 (6%) patients (14.2/1,000 person-years of follow-up). At baseline, patients who developed AF were, compared with those remaining in sinus rhythm, older and had a higher left ventricular mass index a smaller aortic valve area index. Treatment with simvastatin and ezetimibe was not associated with less new-onset AF (odds ratio 0.89 [95% CI 0.57-1.97], P =.717). In contrast, age (hazard ratio [HR] 1.07 [95% CI 1.05-1.10], P <.001) and left ventricular mass index (HR 1.01 [95% CI 1.01-1.02], P <.001) were independent predictors of new-onset AF. The occurrence of new-onset AF was independently associated with 2-fold higher risk of AS-related outcomes (HR 1.65 [95% CI 1.02-2.66], P =.04) and 4-fold higher risk of nonfatal nonhemorrhagic stroke (HR 4.04 [95% CI 1.18-13.82], P =.03). Conclusions: Simvastatin and ezetimibe were not associated with less new-onset AF. Older age and greater left ventricular mass index were independent predictors of AF development. New-onset AF was associated with a worsening of prognosis.

Originalsprog	Engelsk
Tidsskrift	American Heart Journal
Vol/bind	163
Udgave nummer	4
Sider (fra-til)	690-6
Antal sider	7
ISSN	0002-8703
DOI	https://doi.org/10.1016/j.ahj.2012.01.026
Status	Udgivet - apr. 2012

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10.1016/j.ahj.2012.01.026

Citationsformater

Bang, C. N., Greve, A. M., Boman, K., Egstrup, K., Gohlke-Baerwolf, C., Køber, L., Nienaber, C. A., Ray, S., Rossebø, A. B., & Wachtell, K. (2012). Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. American Heart Journal, 163(4), 690-6. https://doi.org/10.1016/j.ahj.2012.01.026

Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis : the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. / Bang, Casper N; Greve, Anders M; Boman, Kurt et al.

I: American Heart Journal, Bind 163, Nr. 4, 04.2012, s. 690-6.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Bang, CN, Greve, AM, Boman, K, Egstrup, K, Gohlke-Baerwolf, C, Køber, L, Nienaber, CA, Ray, S, Rossebø, AB & Wachtell, K 2012, 'Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study', American Heart Journal, bind 163, nr. 4, s. 690-6. https://doi.org/10.1016/j.ahj.2012.01.026

@article{a366feedce934920a7f2e829eb5c2fa1,

title = "Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study",

abstract = "Background: Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS). Methods: Asymptomatic patients with mild-to-moderate AS (n = 1,421) were randomized (1:1) to double-blind simvastatin 40 mg and ezetimibe 10 mg combination or placebo and followed up for a mean of 4.3 years. The primary end point was the time to new-onset AF adjudicated by 12-lead electrocardiogram at a core laboratory reading center. Secondary outcomes were the correlates of new-onset AF with nonfatal nonhemorrhagic stroke and a combined end point of AS-related events. Results: During the course of the study, new-onset AF was detected in 85 (6%) patients (14.2/1,000 person-years of follow-up). At baseline, patients who developed AF were, compared with those remaining in sinus rhythm, older and had a higher left ventricular mass index a smaller aortic valve area index. Treatment with simvastatin and ezetimibe was not associated with less new-onset AF (odds ratio 0.89 [95% CI 0.57-1.97], P =.717). In contrast, age (hazard ratio [HR] 1.07 [95% CI 1.05-1.10], P <.001) and left ventricular mass index (HR 1.01 [95% CI 1.01-1.02], P <.001) were independent predictors of new-onset AF. The occurrence of new-onset AF was independently associated with 2-fold higher risk of AS-related outcomes (HR 1.65 [95% CI 1.02-2.66], P =.04) and 4-fold higher risk of nonfatal nonhemorrhagic stroke (HR 4.04 [95% CI 1.18-13.82], P =.03). Conclusions: Simvastatin and ezetimibe were not associated with less new-onset AF. Older age and greater left ventricular mass index were independent predictors of AF development. New-onset AF was associated with a worsening of prognosis.",

author = "Bang, {Casper N} and Greve, {Anders M} and Kurt Boman and Kenneth Egstrup and Christa Gohlke-Baerwolf and Lars K{\o}ber and Nienaber, {Christoph A} and Simon Ray and Rosseb{\o}, {Anne B} and Kristian Wachtell",

year = "2012",

month = apr,

doi = "10.1016/j.ahj.2012.01.026",

language = "English",

volume = "163",

pages = "690--6",

journal = "American Heart Journal",

issn = "0002-8703",

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number = "4",

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TY - JOUR

T1 - Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis

T2 - the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study

AU - Bang, Casper N

AU - Greve, Anders M

AU - Boman, Kurt

AU - Egstrup, Kenneth

AU - Gohlke-Baerwolf, Christa

AU - Køber, Lars

AU - Nienaber, Christoph A

AU - Ray, Simon

AU - Rossebø, Anne B

AU - Wachtell, Kristian

PY - 2012/4

Y1 - 2012/4

N2 - Background: Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS). Methods: Asymptomatic patients with mild-to-moderate AS (n = 1,421) were randomized (1:1) to double-blind simvastatin 40 mg and ezetimibe 10 mg combination or placebo and followed up for a mean of 4.3 years. The primary end point was the time to new-onset AF adjudicated by 12-lead electrocardiogram at a core laboratory reading center. Secondary outcomes were the correlates of new-onset AF with nonfatal nonhemorrhagic stroke and a combined end point of AS-related events. Results: During the course of the study, new-onset AF was detected in 85 (6%) patients (14.2/1,000 person-years of follow-up). At baseline, patients who developed AF were, compared with those remaining in sinus rhythm, older and had a higher left ventricular mass index a smaller aortic valve area index. Treatment with simvastatin and ezetimibe was not associated with less new-onset AF (odds ratio 0.89 [95% CI 0.57-1.97], P =.717). In contrast, age (hazard ratio [HR] 1.07 [95% CI 1.05-1.10], P <.001) and left ventricular mass index (HR 1.01 [95% CI 1.01-1.02], P <.001) were independent predictors of new-onset AF. The occurrence of new-onset AF was independently associated with 2-fold higher risk of AS-related outcomes (HR 1.65 [95% CI 1.02-2.66], P =.04) and 4-fold higher risk of nonfatal nonhemorrhagic stroke (HR 4.04 [95% CI 1.18-13.82], P =.03). Conclusions: Simvastatin and ezetimibe were not associated with less new-onset AF. Older age and greater left ventricular mass index were independent predictors of AF development. New-onset AF was associated with a worsening of prognosis.

AB - Background: Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS). Methods: Asymptomatic patients with mild-to-moderate AS (n = 1,421) were randomized (1:1) to double-blind simvastatin 40 mg and ezetimibe 10 mg combination or placebo and followed up for a mean of 4.3 years. The primary end point was the time to new-onset AF adjudicated by 12-lead electrocardiogram at a core laboratory reading center. Secondary outcomes were the correlates of new-onset AF with nonfatal nonhemorrhagic stroke and a combined end point of AS-related events. Results: During the course of the study, new-onset AF was detected in 85 (6%) patients (14.2/1,000 person-years of follow-up). At baseline, patients who developed AF were, compared with those remaining in sinus rhythm, older and had a higher left ventricular mass index a smaller aortic valve area index. Treatment with simvastatin and ezetimibe was not associated with less new-onset AF (odds ratio 0.89 [95% CI 0.57-1.97], P =.717). In contrast, age (hazard ratio [HR] 1.07 [95% CI 1.05-1.10], P <.001) and left ventricular mass index (HR 1.01 [95% CI 1.01-1.02], P <.001) were independent predictors of new-onset AF. The occurrence of new-onset AF was independently associated with 2-fold higher risk of AS-related outcomes (HR 1.65 [95% CI 1.02-2.66], P =.04) and 4-fold higher risk of nonfatal nonhemorrhagic stroke (HR 4.04 [95% CI 1.18-13.82], P =.03). Conclusions: Simvastatin and ezetimibe were not associated with less new-onset AF. Older age and greater left ventricular mass index were independent predictors of AF development. New-onset AF was associated with a worsening of prognosis.

U2 - 10.1016/j.ahj.2012.01.026

DO - 10.1016/j.ahj.2012.01.026

M3 - Journal article

C2 - 22520536

SN - 0002-8703

VL - 163

SP - 690

EP - 696

JO - American Heart Journal

JF - American Heart Journal

IS - 4

ER -

Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study

Abstract

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