Statins and prevention of atrial fibrillation in patients with heart failure

Statins are highly effective and widely used lipid-lowering agents in clinical practice, that also display a number of pleiotropic properties beyond cholesterol lowering. Several trials have demonstrated that they reduce cardiovascular morbidity and mortality in both primary and secondary prevention. Atrial fibrillation (AF) and heart failure (HF) represent 2 world-wide epidemics. Recent evidence suggests that statins may have beneficial effects on cardiovascular outcomes in patients with HF, and specifically in the prevention of AF. The anti-arrhythmic mechanisms of statins regarding AF prevention in HF patients are not fully understood but are possibly related to their pleiotropic effects including anti-inflammatory, antioxidant, atrial remodeling attenuation, ion channel stabilization, and autonomic nervous system regulation.