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Could Short-Term Perioperative High-Dose Atorvastatin Offer Antiarrhythmic and Cardio-Protective Effects in Rheumatic
Essam Abd Allah1, Emad Zarief Kamel1, Hany M Osman1
1Anesthesia and ICU department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Objectives:
To evaluate the role of prophylactic high-dose atorvastatin for prevention of postoperative atrial fibrillation (POAF), inflammatory response attenuation, and myocardial protection after valve replacement cardiac surgery.
Design:
Randomized controlled trial.
Setting:
Assiut University Hospitals.
Participants:
Sixty-four adult patients undergoing cardiac valve replacement surgery.
Interventions:
The participants were equally divided into 2 groups. Group S received 80 mg of atorvastatin (oral tablets), 12 and 2 hours preoperatively, and on the 2nd, 3rd, 4th, and 5th postoperative days. Control group C received placebo at the same time periods.
Measurements:
The incidence of POAF, postoperative white blood cell count, serum C-reactive protein, interleukin 6, and troponin I.
Main Results:
Group S patients showed a lower incidence of POAF compared with the placebo group (p = 0.031). The white blood cell count showed significant reductions in group S compared with group C on the second, third, fourth, and fifth postoperative days. The C-reactive protein level showed significant reductions on the third, fourth, and fifth postoperative days in group S compared with group C (p = 0.001, 0.001, and 0.001, respectively). The serum level of interleukin 6 showed a significant reduction on the fifth postoperative day in group S compared with group C (p = 0.001). There was no significant difference between the 2 groups regarding the troponin I level and inotropic score.
Conclusion:
Prophylactic use of high dose atorvastatin can decrease the incidence of POAF and attenuate the inflammatory process in adult patients undergoing isolated rheumatic cardiac valve replacement surgery.
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