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Atorvastatin prevents postoperative atrial fibrillation in patients undergoing cardiac surgery

Chen Sai1, Jiang Li1, Ma Ruiyan1

  • 1Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|January 9, 2018
PubMed

Insights

Statin therapy, particularly atorvastatin, significantly reduces the risk of postoperative atrial fibrillation (AF) after cardiac surgery. Moderate doses appear most effective, especially for patients undergoing coronary artery bypass grafting (CABG).

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Observational studies suggest statins may reduce postoperative atrial fibrillation (AF) in cardiac surgery patients.
  • Retrospective studies have yielded conflicting results regarding statin efficacy for AF prevention.
  • The study aimed to clarify the impact of different statins and doses on postoperative AF risk.

Purpose of the Study:

  • To evaluate the effectiveness of various statins in reducing the risk of postoperative atrial fibrillation (AF).
  • To determine if different statin dosages influence the prevention of AF after cardiac surgery.
  • To analyze the impact of statin therapy on AF in patients undergoing specific procedures like coronary artery bypass grafting (CABG).

Main Methods:

  • A systematic search of PubMed, EMBASE, and Cochrane Database for randomized controlled trials (RCTs) up to June 2016.
  • Inclusion of 18 RCTs involving 4003 statin-naive patients undergoing cardiac surgery.
  • Application of a random-effects model to address heterogeneity in study results.

Main Results:

  • Overall statin therapy significantly decreased the risk of AF (RR: 0.57, 95% CI: 0.45-0.73).
  • Atorvastatin demonstrated a significant reduction in new-onset AF risk (RR: 0.53, 95% CI: 0.41-0.69).
  • Moderate-dose statin therapy appeared optimal (RR: 0.42, 95% CI: 0.28-0.64), with benefits noted in CABG patients (RR: 0.52, 95% CI: 0.39-0.68).

Conclusions:

  • Statin therapy offers a protective effect against postoperative AF.
  • Atorvastatin, particularly at moderate doses, is associated with a reduced risk of new-onset AF in post-CABG patients.
  • Simvastatin may help prevent AF recurrence; further prospective studies are recommended.
Abstract

Keywords:
AtorvastatinAtrial fibrillationCoronary artery bypass graftMeta-analysis

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