The Effect of a High Dose of Atorvastatin on the Occurrence of Atrial Fibrillation After Coronary Artery Bypass Grafting

Karimi, A; Bidhendi, Leila Mohammadi; Rezvanfard, Mehrnaz; Bina, Payvand; Yousefi, Arezou; Molai, Maliheh; Zare, Elmira; Fathollahi, Mahmood Sheikh; Sadeghian, Saeed

doi:10.1016/j.athoracsur.2012.01.054

Cited by 24 publications

(17 citation statements)

References 39 publications

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“…With regard to statins, it has occasionally been reported that POAF is prevented by preoperative stain administration due to the anti-inflammatory effect of these drugs, 16) while an opposite result was obtained in this study. Although the reason is unknown, statins were only administered to 29% of the patients preoperatively and many of them had a history of ischemic heart disease, suggesting that performance of emergency surgery and high age may have influenced this result.…”

Section: Discussioncontrasting

confidence: 49%

A Study on the Occurrence and Prevention of Perioperative Stroke after Coronary Artery Bypass Grafting

Sezai

Nakata

Iida

et al. 2015

ATCS

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Cerebral infarction after coronary artery bypass grafting (CABG) is a serious complication and a problem that remains unsolved. We will report the onset of cerebral infarction in CABG patients in our institution, and its cause, preventive method. The subjects of this research were 761 patients who underwent on-pump isolated CABG. Preoperative, intraoperative and postoperative factors, onset of cerebral infarction and atrial fibrillation were investigated. Postoperative cerebral infarction and postoperative atrial fibrillation were recognized in 1.4% and 24% of the patients, respectively. The risk factors for cerebral infarction were carotid artery stenosis,

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Section: Discussioncontrasting

confidence: 49%

A Study on the Occurrence and Prevention of Perioperative Stroke after Coronary Artery Bypass Grafting

Sezai

Nakata

Iida

et al. 2015

ATCS

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“…A recent meta-analysis of studies examining prophylactic administration of the antioxidant N-acetylcysteine, to cardiac surgery patients revealed that pretreatment with this compound could significantly decrease the incidence of post-operative AF [68]. Similar results have been obtained with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors such as atorvastatin, and abrogation of inflammatory pathways leading to ROS generation have been postulated to be the way in which these drugs reduce post-operative AF [69]. As with results from animal models, these studies warrant careful interpretation.…”

Section: Aging Ros and Afmentioning

confidence: 70%

Atrial fibrillation in the elderly: the potential contribution of reactive oxygen species

Schillinger

Patel

2013

Journal of Geriatric Cardiology

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Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia, and is a significant source of healthcare expenditures throughout the world. It is an arrhythmia with a very clearly defined predisposition for individuals of advanced age, and this fact has led to intense study of the mechanistic links between aging and AF. By promoting oxidative damage to multiple subcellular and cellular structures, reactive oxygen species (ROS) have been shown to induce the intra- and extra-cellular changes necessary to promote the pathogenesis of AF. In addition, the generation and accumulation of ROS have been intimately linked to the cellular processes which underlie aging. This review begins with an overview of AF pathophysiology, and introduces the critical structures which, when damaged, predispose an otherwise healthy atrium to AF. The available evidence that ROS can lead to damage of these critical structures is then reviewed. Finally, the evidence linking the process of aging to the pathogenesis of AF is discussed.

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“…While it is possible that had we used higher atorvastatin doses in our study that this may have affected our inflammatory marker results, this is unlikely, as other investigators have examined the effects of maximal doses of atorvastatin (80 mg) on inflammatory marker levels and did not find any differences after 1 week of treatment. 24 In contrast, nonsurgical patients with acute coronary syndromes who were randomized to receive atorvastatin had significant reductions in CRP and MPO levels 1 week after therapy, compared with patients who received placebo. 12 Kim et al showed that patients who developed AF after CABG had greater NADPH oxidase activity in atrial tissue but did not differ in systemic markers of oxidative stress, compared with patients who did not develop POAF.…”

Section: Discussionmentioning

confidence: 96%

Beneficial effects of perioperative statins for major pulmonary resection

Amar

Park

Zhang

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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Objectives Statins improve overall outcomes after noncardiac surgery. The primary aim of the study was to determine whether use of perioperative atorvastatin reduced the rate of postoperative complications in patients undergoing pulmonary resection. Methods This was a prospective, randomized, placebo-controlled double-blind trial of patients undergoing elective pulmonary resection who received either atorvastatin (40 mg daily) or placebo beginning 1 week before surgery and continued for 1 week postoperatively. Patient characteristics and postoperative complications were recorded. Plasma inflammatory markers were sampled at baseline, in the PACU and on postoperative day 3. Due to difficulty enrolling statin-naive patients, the study was stopped at the interim analysis. Results Postoperative complications occurred in 16 of 72 (22%) patients receiving placebo and in 8 of 65 (12%) receiving atorvastatin, P=0.13). For patients undergoing major anatomic resection, there were a total of 24 complications in 15 of 45 patients who received placebo and 8 complications in 7 of 43 atorvastatin-treated patients (P=0.04). Plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNFα), and myeloperoxidase (MPO) did not differ between the two treatment arms during the study. Conclusions After a 2-week perioperative course of atorvastatin (40 mg) in statin-naïve patients undergoing major pulmonary resection we found evidence of a reduction in the number of clinically important cardiovascular and pulmonary complications compared with placebo. These promising results merit evaluation in a larger, perhaps multicenter study.

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The Effect of a High Dose of Atorvastatin on the Occurrence of Atrial Fibrillation After Coronary Artery Bypass Grafting

Cited by 24 publications

References 39 publications

A Study on the Occurrence and Prevention of Perioperative Stroke after Coronary Artery Bypass Grafting

A Study on the Occurrence and Prevention of Perioperative Stroke after Coronary Artery Bypass Grafting

Atrial fibrillation in the elderly: the potential contribution of reactive oxygen species

Beneficial effects of perioperative statins for major pulmonary resection

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