Reduced P-selectin in hearts pretreated with fluvastatin: a novel benefit for patients undergoing open heart surgery.
OBJECTIVE
P-selectin is an adhesion molecule that plays a role in the pathogenesis of atherosclerosis. The aim of this study was to assess whether or not the treatment with fluvastatin for 3 weeks preoperatively would reduce the levels of circulating P-selectin in patients with coronary heart disease undergoing coronary artery bypass grafting surgery (CABG).


METHODS
Forty-six patients referred to CABG operation were included in the study. The patients were randomized into two groups (1:1): one treated with fluvastatin (80 mg/day, fluvastatin group, n = 23), and the other one treated with placebo (placebo group, n = 23) for three weeks before surgery. All patients underwent CABG using CPB. Blood samples were collected at baseline (the day before surgery), before and after aortic cross-clamping (ACC), at postoperative 0 h (the end of surgical intervention), and at 4, 12, and 24 hours postoperatively. Concentrations of soluble P-selectin (sP-selectin) were analyzed.


RESULTS
The sP-selectin values measured in the fluvastatin group were significantly lower than the values measured in the placebo group. There was less use of intraoperative inotropic agents in the fluvastatin group ( P < 0.015) and the difference in the length of ICU and hospital stay showed a significantly shorter stay for the fluvastatin group.


CONCLUSIONS
Pretreatment with fluvastatin seemed to reduce P-selectin levels compared to patients given placebo, and hence, we think that pretreatment with a statin, fluvastatin in our study, might reduce the perioperative cardiac injury caused by cardiopulmonary bypass-induced inflammatory changes. We believe that routine preoperative use of fluvastatin should be carefully considered.
Berkan
O
O
Department of Cardiovascular Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey.
Katrancioglu
N
N
Ozker
E
E
Ozerdem
G
G
Bakici
Z
Z
Yilmaz
M B
MB
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D003422:Critical Care; D015536:Down-Regulation; D004334:Drug Administration Schedule; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007211:Indoles / Q000008:administration & dosage*; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D019007:P-Selectin / Q000097:blood*; D011300:Preoperative Care; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D002316:Cardiotonic Agents; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D019007:P-Selectin; D000077340:Fluvastatin