Effect of Preoperative Atorvastatin Therapy on Atrial Fibrillation Following Off-Pump Coronary Artery Bypass Grafting

Ji, Qiang; Mei, Yunqing; Wang, Xisheng; Sun, Yifeng; Feng, Jing; Cai, Jun; Xie, Songqiang; Chi, Liangjie

doi:10.1253/circj.cj-09-0352

Cited by 74 publications

(64 citation statements)

References 19 publications

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“…The results of our analysis, which was robust in sensitivity analyses, suggest that statin therapy may reduce the incidence of postoperative AF by 45% in patients undergoing cardiac surgery, and strengthens the results of the randomized trial by Ji et al 1 …”

Section: To the Editorsupporting

confidence: 84%

Effect of Preoperative Statin Therapy on Postoperative Atrial Fibrillation in Cardiac Surgery

Takagi

Umemoto

2010

Circ J

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Section: To the Editorsupporting

confidence: 84%

Effect of Preoperative Statin Therapy on Postoperative Atrial Fibrillation in Cardiac Surgery

Takagi

Umemoto

2010

Circ J

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“…In addition, some upstream therapies using statins, ARB, etc., to suppress construction of the arrhythmogenic substrate may be effective if administered in the precursor state for AF. 1,2,[26][27][28] Prospective studies will be necessary to prove the hypothesis. Limitations: There were several limitations in this study.…”

Section: Discussionmentioning

confidence: 99%

Prediction of New Onset Atrial Fibrillation Through P Wave Analysis in 12 Lead ECG

Yoshizawa

Niwano

et al. 2014

Int. Heart J.

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SummaryIt is unknown whether 12-lead ECG can predict new-onset AF. In the present study, we identified patients with new onset AF from our digitally stored ECG database, and the P wave morphologies were analyzed in their preceding sinus rhythm recordings as the precursor state for AF. The P wave was analyzed in the most recent ECG recording of sinus rhythm preceding new onset AF within 12 months. The duration and amplitude of P waves were analyzed in 12 leads and compared between the 2 groups with the other clinical parameters. The study population consisted of 68 patients with new-onset AF and 68 age and sex-matched controls. Multivariate analysis revealed that the P wave amplitude in leads II and V 1 (0.157 ± 0.056 versus 0.115 ± 0.057 mV, P = 0.032, and 0.146 ± 0.089 versus 0.095 ± 0.036 mV, P = 0.002) and P wave dispersion (56.9 ± 14.8 versus 33.5 ± 12.9 ms, P = 0.001) were significant independent factors for the prediction of new-onset AF. By using these factors, new-onset AF could be predicted with a sensitivity of 69.1% and specificity of 88.2%. P wave analysis is useful for predicting new onset AF. (Int Heart J 2014; 55: 422-427) Key words: P wave dispersion, P wave duration, Atrial remodeling A lthough several experimental studies predicted a preventive effect of upstream therapies for atrial fibrillation (AF) using angiotensin receptor blockades (ARBs), 1,2) recent clinical trials of such upstream therapies have failed to demonstrate their preventive effect in clinical cases. The reason for this discrepancy is unclear; however, it may be partly explained by the heterogeneity of the pathogenic conditions of AF in clinical cases.3,4) Because a meta-analysis of ARB studies 2) has suggested a possible effect of ARB in the prevention of new-onset AF in clinical cases, upstream therapy may possibly exhibit an effect if it could be performed in the precursor state of AF. Even when considering catheter ablation for AF, it is important to detect the early or precursor state of AF in clinical cases because the effect of catheter ablation is higher in patients with earlier-stage AF, even in those with simple circumference ablation of pulmonary veins.5-7) The arrhythmogenic substrate of AF is known to be constructed progressively under various pathological conditions, including AF itself; 7-11) therefore, it could be speculated that the electrophysiological properties of the atrium may be modified in its precursor state. Several studies have attempted to identify the changes in P waves during sinus rhythm in AF patients. 7,8,[12][13][14][15][16] In these reports, prolongation of the P wave duration or expansion of the dispersion of the P wave duration in the surface 12-lead electrocardiogram (ECG) have been focused on as indices for identification of AF patients. [10][11][12][13][14][15] In the present study, we retrospectively identified patients with new-onset AF in the digital ECG profiling system of our hospital, and P waves in the preceding sinus rhythm state were analyzed as the precursor state for new-on...

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“…However, those trials involved small numbers of patients and had other important limitations. For example, only same of the trials were designed with a prespecified postoperative AF as an outcome (16,29,30), and only one trial (29) included an intention-to-treat analysis of the effect on AF as detected in a systematic and blinded manner. Furthermore, a recent systematic Cochrane review of those trials showed evidence of selective reporting and publication bias (31).…”

Section: Discussionmentioning

confidence: 99%

The statin therapy to prevent atrial fibrillation after cardiac surgery: Shakespearean dilemma

Calcagno¹,

Stio²,

Mancone³

et al. 2016

J. Thorac. Dis.

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Effect of Preoperative Atorvastatin Therapy on Atrial Fibrillation Following Off-Pump Coronary Artery Bypass Grafting

Cited by 74 publications

References 19 publications

Effect of Preoperative Statin Therapy on Postoperative Atrial Fibrillation in Cardiac Surgery

Effect of Preoperative Statin Therapy on Postoperative Atrial Fibrillation in Cardiac Surgery

Prediction of New Onset Atrial Fibrillation Through P Wave Analysis in 12 Lead ECG

The statin therapy to prevent atrial fibrillation after cardiac surgery: Shakespearean dilemma

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