Table 3.

Hazard ratios of longstanding persistent atrial fibrillation for alternative definitions of longstanding persistent atrial fibrillation^a

Medication use	Events	Person-years	Fully adjustedb
			HR	95% CI
Longstanding persistent AF definition: AF present on four separate occasions with the first and fourth occasions 6–36 months apart with no documented sinus rhythm in between
Overall	183	5,413
Statins: Non-laggedc
Never use	101	2,711	1.00	reference
Current use	53	2,031	0.84	0.58, 1.23
Former use	29	671	1.45	0.92, 2.28
Statins: Laggedd
Never use one year prior	117	3,065	1.00	reference
Current use one year prior	48	1,769	0.91	0.61, 1.35
Former use one year prior	17	571	0.98	0.57, 1.70
ACE inhibitors or ARBs: Non-laggedc
Never use	68	1,919	1.00	reference
Current use	76	2,365	0.91	0.62, 1.35
Former use	39	1,129	0.92	0.60, 1.43
ACE inhibitors or ARBs: Laggedd
Never use one year prior	79	2,209	1.00	reference
Current use one year prior	68	2,165	0.99	0.67, 1.47
Former use one year prior	35	1,031	0.98	0.63, 1.52
Beta-blockersc,e
Current nondihydropyridine CCB use	16	436	1.00	reference
Current beta-blocker use	93	2,615	1.06	0.62, 1.80
Longstanding persistent AF definition: AF present on two separate occasions 12–36 months apart with no documented sinus rhythm in between
Overall	239	4,626
Statins: Non-laggedc
Never use	136	2,334	1.00	reference
Current use	70	1,717	0.81	0.58, 1.13
Former use	33	575	1.15	0.76, 1.74
Statins: Laggedd
Never use one year prior	150	2,652	1.00	reference
Current use one year prior	65	1,480	1.00	0.71, 1.41
Former use one year prior	23	487	1.06	0.66, 1.70
ACE inhibitors or ARBs: Non-laggedc
Never use	89	1,666	1.00	reference
Current use	109	2,005	1.01	0.73, 1.41
Former use	41	955	0.75	0.50, 1.13
ACE inhibitors or ARBs: Laggedd
Never use one year prior	104	1,931	1.00	reference
Current use one year prior	93	1,820	1.05	0.75, 1.48
Former use one year prior	41	876	0.89	0.60, 1.33
Beta-blockersc,e
Current nondihydropyridine CCB use	26	358	1.00	reference
Current beta-blocker use	118	2,254	0.78	0.51, 1.20
Longstanding persistent AF definition: AF present on two separate occasions 6–18 months apart with no documented sinus rhythm in between
Overall	258	5,224
Statins: Non-laggedc
Never use	144	2,594	1.00	reference
Current use	78	1,975	0.80	0.58, 1.10
Former use	36	655	1.12	0.75, 1.67
Statins: Laggedd
Never use one year prior	164	2,940	1.00	reference
Current use one year prior	72	1,718	0.90	0.65, 1.25
Former use one year prior	21	558	0.79	0.49, 1.28
ACE inhibitors or ARBs: Non-laggedc
Never use	89	1,863	1.00	reference
Current use	107	2,267	0.96	0.68, 1.33
Former use	62	1,094	1.11	0.77, 1.61
ACE inhibitors or ARBs: Laggedd
Never use one year prior	104	2,149	1.00	reference
Current use one year prior	98	2,072	1.07	0.76, 1.50
Former use one year prior	55	995	1.17	0.81, 1.69
Beta-blockersc,e
Current nondihydropyridine CCB use	23	407	1.00	reference
Current beta-blocker use	132	2,502	1.02	0.65, 1.59

Abbreviations: ACE, angiotensin-converting enzyme; AF, atrial fibrillation; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; CI, confidence interval; HR, hazard ratio

^aThe definition of longstanding persistent AF used in primary analyses (see Table 2) was AF present on two separate occasions 6–36 months apart without any documented sinus rhythm.

^bAdjusted for age, sex, body mass index, diabetes, hypertension, coronary heart disease, valvular heart disease, heart failure, prior stroke, chronic kidney disease, and current use of antiarrhythmic medication. Models for statins were also adjusted for total cholesterol:HDL ratio. Models for ACE inhibitors or ARBs and for beta-blockers were also adjusted for systolic and diastolic blood pressure.

^cNever, current, and former medication use as of the previous day of follow-up.

^dTo reduce healthy user bias, statin use and ACE inhibitor or ARB use were lagged by one year.

^eTo reduce confounding by indication, current beta-blocker use was compared with current nondihydropyridine CCB use. Person-time with concurrent use of both a beta-blocker and a nondihydropyridine CCB and person-time with no current use of either a beta-blocker or a nondihydropyridine CCB was excluded.