SUMMARY The use of statins was significantly associated with a decreased risk of atrial fibrillation in patients with sinus rhythm .
PURPOSE OF REVIEW Whether statins may prevent  atrial fibrillation  remains a subject of debate .
The incidence and risk factors for new onset atrial fibrillation in the PROSPER study.
AIMS Atrial fibrillation/flutter ( AF ) is the most common arrhythmia in older people . It associates with reduced exercise capacity , increased risk of stroke , and mortality . We aim ed to determine retrospectively whether pravastatin reduces the incidence of AF and whether any electrocardiographic measures or clinical conditions might be risk factors for its development . METHODS AND RESULTS The PROspect i ve Study of Pravastatin in the Elderly at Risk ( PROSPER ) was a r and omized , double-blind controlled trial that recruited 5804 individuals aged 70 - 82 years with a history of , or risk factors for , vascular disease . A total of 2891 were allocated to pravastatin  and 2913 to  placebo ; mean follow-up was 3.2 years .  Electrocardiograms ( ECGs ) , which were recorded at baseline , annually thereafter , and at run-out , were processed by computer and review ed manually . In all , 264 of 2912 ( 9.1 % ) of the placebo group and 283 of 2888 ( 9.8 % ) of the pravastatin-treated group developed AF [ hazard ratio 1.08 ( 0.92,1.28 ) , P= 0.35 ) ] . Multivariate analysis showed that PR and QTc intervals , age , left ventricular hypertrophy , and ST-T abnormalities were related to development of AF after adjustment for many variables including alcohol consumption , which itself was univariately predictive of developing AF . Previous myocardial infa rct ion on the ECG was not a risk factor . A history of vascular disease was strongly linked with developing AF but not diabetes and hypertension . CONCLUSION Pravastatin does not reduce the incidence of AF in older people at risk of vascular disease , at least in the short-medium term . Risk factors for AF include older age , prolongation of PR or QTc intervals , left ventricular hypertrophy , and ST-T abnormalities on the ECG
SUMMARY The use of statins was significantly associated with a decreased risk of atrial fibrillation in patients with sinus rhythm .
PURPOSE OF REVIEW Whether statins may prevent  atrial fibrillation  remains a subject of debate .