Statins and Postoperative Risk of Atrial Fibrillation Following Coronary Artery Bypass Grafting

Marı́n, Francisco; Pascual, Domingo; Roldán, Vanessa; Arribas, José María; Ahumada, Miguel; Tornel, Pedro L.; Oliver, Clara; Gómez-Plana, Jesús; Lip, Gregory Y.H.; Valdés, Mariano

doi:10.1016/j.amjcard.2005.07.124

Cited by 197 publications

(118 citation statements)

References 28 publications

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“…9,10) CRP can be used to measure systemic inflammation in clinical settings. 8,11,12) In this study, the postoperative mean peak CRP level was higher in patients who developed postoperative atrial fibrillation (168.3 ± 29.1 mg/L versus 112.6 ± 19.6 mg/L in patients without atrial fibrillation, P < 0.0001), and logistic regression analysis showed postoperative CRP levels above the median value were associated with increased risk of postoperative atrial fibrillation (2.421, P = 0.015).…”

Section: Discussionmentioning

confidence: 99%

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Sun

Mei

et al. 2011

Int. Heart J.

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SummaryAtrial fibrillation (AF) is one of the most common postoperative arrhythmias in patients who undergo coronary artery bypass grafting (CABG). The aim of this study was to evaluate the effect of preoperative atorvastatin on postoperative atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass (CCABG). One hundred consecutive patients undergoing elective CCABG, without history of AF or previous statin treatment, were enrolled and randomly assigned to a statin group (atorvastatin 20 mg/d, n = 49) or a control group (placebo, n = 51) starting 7 days preoperatively. The primary endpoint was the occurrence of postoperative AF. C-reactive protein (CRP) levels were assessed in all selected patients before surgery and every 24 hours postoperatively until discharge from hospital. Atorvastatin significantly reduced the incidence of postoperative AF and postoperative peak CRP level versus placebo (18% versus 41%, P = 0.017; 129.3 ± 24.3 mg/L versus 149.3 ± 32.5 mg/L, P < 0.0001). Kaplan-Meier curves confirmed a significantly better postoperative atrial fibrillation-free survival in the statin group (χ 2 = 7.466, P = 0.006). Logistic regression analysis showed preoperative atorvastatin treatment was an independent factor associated with a significant reduction in postoperative AF (OR = 0.235, P = 0.007), whereas high postoperative CRP levels were associated with increased risk (OR = 2.421, P = 0.015). Preoperative atorvastatin administration may inhibit inflammatory reactions to prevent atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass. (Int Heart J 2011; 52: 7-11) Key words: Coronary artery bypass grafting, Cardiopulmonary bypass, Atorvastatin, Atrial fibrillation A trial fibrillation (AF) is one of the most important complications after coronary artery bypass grafting (CABG) and has an incidence of approximately 30%.1,2) Atrial fibrillation can severely influence hemodynamic stability; it can induce loss of atrial pump function resulting in impairment of ventricular filling with a decrease in cardiac output and an increase in incidence of stroke, thus contributing to the rise of postoperative disability and mortality.3) For patients with atrial fibrillation, especially in those after CABG, a rapid ventricular rate significantly increases myocardial oxygen consumption, induces cardiac insufficiency, and aggravates myocardial ischemia; it can even lead to tachycardiomyopathy, which can severely threaten the life of the patient. Therefore, it is very important to prevent atrial fibrillation following CABG. Recent studies found that atrial fibrillation after CABG may be associated with inflammatory response, and statins have been shown to inhibit such inflammatory response, and reduce the incidence of AF after CABG. [4][5][6][7][8] Nevertheless, since atrial fibrillation has a significant genetic heterogeneity and the effects of the drugs used to treat the latter are different among different races, exploring the effects of statins on postoperative...

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Section: Discussionmentioning

confidence: 99%

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Sun

Mei

et al. 2011

Int. Heart J.

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“…44 Finally, we found that preoperative statin use was associated with a 60% risk reduction in POAF incidence. The antiarrhythmic mechanism of statins can possibly be explained by their effects on inflammation 45,46,47,48 , antioxidant effects 49,50 , antiarrhythmic effects due to ion channel stabilization 51 , a role in extracellular matrix modulation 52 , an inhibition of synthesis of isoprenoids that are significant for the posttranslational modification of such signalling molecules as Rho, Rac, and Ras…”

Section: Discussionmentioning

confidence: 99%

The influence of preoperative pharmacotherapy on the appearance of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting

Vukićević¹,

Putnik²,

Potpara³

2016

Srce i krvni sudovi

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“…But there are several studies which showed different outcomes in the prophylactic use of statins. [11][12][13] Whether statins would maintain efficacy in preventing AF following cardiac surgery has not been verified.…”

Section: 3mentioning

confidence: 99%

Effect of Statins in Preventing Postoperative Atrial Fibrillation Following Cardiac Surgery

Liang

Wang

et al. 2010

Heart, Lung and Circulation

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Statins and Postoperative Risk of Atrial Fibrillation Following Coronary Artery Bypass Grafting

Cited by 197 publications

References 28 publications

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

The influence of preoperative pharmacotherapy on the appearance of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting

Effect of Statins in Preventing Postoperative Atrial Fibrillation Following Cardiac Surgery

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