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Statins may lower nonvascular dementia risk in patients with AF
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Patients with atrial fibrillation who used statins may be less likely to develop nonvascular dementia compared with those who do not use statins.
AF is associated with cognitive decline and may increase risk for dementia, but the effect of statins on that relationship had not yet been studied, according to the study background. Previous research has indicated a lower risk for dementia in the general population of statin users.
Researchers analyzed data on adults with AF aged 60 years or older collected from the National Health Insurance Research Database of Taiwan. Based on age and sex, they matched 51,253 adults with AF treated with statins with 205,015 adults with AF who had not been exposed to statins (mean age, 73.2 years; 49.7% men; 92.5% with hypertension).
The primary endpoint was nonvascular dementia. Patients were diagnosed with AF between 1996 and 2011 and were followed for 10 years or until the end of the study.
Tze-Fan Chao, MD, and colleagues found that the annual incidence of nonvascular dementia was lower among statin users compared with the nonstatin group (1.89% vs. 2.2%; P < .001).
They determined that statin use was protective against incidence of nonvascular dementia (adjusted HR = 0.832; 95% CI, 0.801-0.864).
Chao, from the division of cardiology in the department of medicine of Taipei Veterans General Hospital and the institute of clinical medicine and the cardiovascular research center of National Yang-Ming University, Taipei, Taiwan, and colleagues also analyzed patients according to the type of statin they had been exposed to. The researchers determined that rosuvastatin (Crestor, AstraZeneca) was associated with the largest reduction in risk for nonvascular dementia (adjusted HR = 0.662; 95% CI, 0.602-0.727).
Atorvastatin (adjusted HR = 0.834; 95% CI, 0.788-0.883), pravastatin (adjusted HR = 0.785; 95% CI, 0.696-0.885) and simvastatin (adjusted HR = 0.885; 95% CI, 0.813-0.963) also were associated with reduced risk for nonvascular dementia among those with AF, but fluvastatin (adjusted HR = 0.966; 95% CI, 0.876-1.066) and lovastatin (adjusted HR = 0.932; 95% CI, 0.835-1.04) were not.
Chao and colleagues also found that longer duration of statin exposure was associated with lower risk for nonvascular dementia. Compared with statin users in the lowest quartile for exposure, statin users in the highest quartile had a more than 70% reduction in risk for nonvascular dementia of more than 70% (adjusted HR = 0.274; 95% CI, 0.247-0.303).
“The present study shows that statins may be able to prevent nonvascular dementia in patients with AF,” the researchers wrote. “Statins should be considered as a potential treatment for patients with AF aged [at least] 60 years to prevent nonvascular dementia in addition to lowering lipid levels.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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