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The effect of a high dose of atorvastatin on the occurrence of atrial fibrillation after coronary artery bypass grafting
Annals of Thoracic Surgery, 07/02/2012
Clinical Article
Karimi A et al. – Atorvastatin pretreatment significantly reduced the occurrence of atrial fibrillation (AF) after bypass grafting; nonetheless, the difference between the beneficial effects of intensive and routine atorvastatin treatments on postoperative AF was not significant.
Methods- Authors retrospectively studied 1,839 consecutive patients (1,177 men [73.2%]) who underwent isolated coronary artery bypass grafting and had no history of previous AF, pacemaker implantation, or antiarrhythmic medication.
- Data recorded included the atorvastatin dose during hospitalization, demographic, echocardiographic, and angiographic data, medical history, drug treatment, and procedural characteristics.
- Continuous telemonitoring during the first 72 postoperative hours assessed for AF, which was defined as episodes lasting more than 5 minutes.
- The dose–related effect of atorvastatin on postoperative AF was investigated by logistic analysis in 1,607 patients: 75 (4.7%) did not receive atorvastatin vs 1,047 (65.1%) and 485 (30.2%) who received 40 mg/d or 80 mg/d, respectively, for at least 3 days before the operation.
- The study population was a mean age of 60.6 ± 9.5 years.
- Multivariate logistic regression demonstrated that a lack of atorvastatin pretreatment along with older age, enlarged left atrium, and male sex, and not taking β–blockers, tended to be associated with an increased risk of postoperative AF.
- There was no significant difference between the effect of a higher (80 mg/d) and a lower dose (40 mg/d) in reducing postoperative AF.