Effects of varied dosage atorvastatin on inflammatory factors and prognosis in aged patients with coronary heart disease and atrial fibrillation

Objective To observe the effects of different dosages of atorvastatin on serum inflammatory factors and prognosis in patients with coronary heart disease(CHD) and atrial fibrillation(AF),and to investigate the possible mechanism of atorvastatin against AF.Methods One hundred CHD patients with AF were randomly divided into two groups:10 mg atorvastatin group(n=50) and 20 mg atorvastatin group(n=50).The levels of serum inflammatory factors,high sensitive C-reactive protein(hsCRP),tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),also left atrium diameter(LAD) and atrial natriuretic peptide(ANP) in two groups were observed before and after treatment.At the same time,maintenance rate of sinus rhythm and incidence rate of embolism were recorded at the 6th month after treatment.Results The serum levels of hsCRP,IL-6,TNF-α were significantly decreased in 6 months after treatment in both groups compared to those before treatmen,20 mg atorvastatin group,hsCRP(4.10±1.85) mg/L vs(6.42±1.71) mg/L,IL-6(11.71±1.69) ng/L vs(14.61±2.47) ng/L,TNF-α(18.07±2.67) ng/L vs(22.32±3.51) ng/L,ANP(213.10±28.20) ng/L vs(352.10±58.71) ng/L,LAD(38.8±7.1) mm vs(50.2±8.7) mm(P0.05),especially in the 20 mg atorvastatin group(P0.05).LAD and ANP in 20 mg atorvastatin group were significantly more reduced than those in 10 mg atorvastatin(P0.05).Maintenance rate of sinus rhythm was significantly higher and incidence rate of embolism was obviously lower in 20 mg atorvastatin group than that in 10 mg atorvastatin group at the 6th month(P0.05).Conclusion Atorvastatin could reduce the levels of serum inflammatory factors,LAD,ANP and incidence rate of embolism and it could increase the maintenance rate of sinus rhythm in AF patients.Those effects were dose-dependent.The inhibitory effect of atorvastatin on serum inflammatory factors may be one of its anti-AF mechanisms.