Combined treatment with valsartan and fluvastatin to delay disease progression in nonpermanent atrial fibrillation with hypertension: A clinical trial

Clin Cardiol. 2020 Dec;43(12):1592-1600. doi: 10.1002/clc.23487. Epub 2020 Oct 26.

Abstract

Background: Atrial fibrillation (AF) is a complex cardiac arrhythmia in clinical practice with increasing incidence. However, the effects of statins on patients with AF are not quite clear.

Hypothesis: To investigate the protective effect of calcium channel blocker (CCB) and valsartan combined fluvastatin on hypertension (HTN) patients with nonpermanent AF.

Methods: In three and a half years, 189 cases of patients diagnosed as HTN combining nonpermanent AF by eight medical centers, were recruited and randomly assigned to four groups with varied treatments: CCB group; CCB + statin group; valsartan group; and valsartan + statin group. The four groups were followed up for 24 months. The 7-day Holter ultrasound echocardiography (UCG) and biochemical indexes were completed at preset time nodes respectively.

Results: After 24 months of follow-up, 178 patients completed the study. Compared with CCB group, the blood lipid level, inflammatory index, ultrasonic index and electrocardiographic measurement results of CCB + statin group, valsartan group and valsartan + statin group were improved in different degrees and had statistical significance (P < .05 or P < .01). Furthermore, the improvement trend of CCB + statin group and valsartan + statin group was more obvious.

Conclusions: The results indicated that valsartan can reduce AF load and recurrence rate, and delay the progression of nonpermanent AF to permanent AF in multiple ways, and the effect of combination of valsartan and fluvastatin is more significant. These results provide a new direction for the integrated upstream control strategy of AF.

Keywords: 7-day Holter monitoring; atrial fibrillation; fluvastatin; randomized controlled clinical trial; valsartan.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / physiopathology
  • Blood Pressure / drug effects*
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Fluvastatin / therapeutic use*
  • Heart Rate / drug effects*
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Valsartan / therapeutic use*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Fluvastatin
  • Valsartan