Statins Combined with Anticoagulants on Heart Failure in Atrial Fibrillation Patients: A Disproportionality Analysis Based on the FAERS Database

Statins and anticoagulants are widely used in atrial fibrillation (AF) patients, but their combined effects on heart failure remain unclear. This study aims to investigate the impact of statins combined with anticoagulants on heart failure in AF patients. A disproportionality analysis was conducted on relevant data from the FAERS database spanning from Q1 2004 to Q2 2024. Seven statins and five direct oral anticoagulants (DOACs) were included. Adverse events were identified using MedDRA 25.0, with Reporting Odds Ratio (ROR) used for signal detection and Ω shrinkage for drug interaction detection. Sensitivity analysis excluded potential confounders. Compared with AF patients not receiving statins, statin users showed a higher reporting risk of heart failure (ROR 1.60, 95% CI 1.51–1.69), with pitavastatin demonstrating the strongest association (ROR 2.47, 95% CI 1.78–3.45). However, in statin users, the addition of anticoagulants did not increase the risk of heart failure (ROR 0.60 [95% CI 0.55-0.66]). This study suggests that while the combination of statins and anticoagulants may increase the risk of heart failure in AF patients, the risk varies among different statins.