Effects of preoperative statin treatment on the incidence of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.
BACKGROUND
Postoperative atrial fibrillation is still a common complication in patients undergoing coronary artery bypass grafting. The aim of this study was to evaluate the effect of preoperative statin therapy on new onset of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.


METHODS
Of 8,946 patients undergoing isolated coronary artery bypass grafting at the Bristol Heart Institute from April 1996 to September 2006, 6,321 (70.6%) received preoperative statins. Of these, 2,152 patients (statin group) were matched to a control group (no statin) by propensity score analysis.


RESULTS
Preoperative characteristics, number of distal anastomoses, and the use of off -pump procedures were similar in both groups. Hospital mortality was 1.3% (56 patients) with no difference between the two groups. Postoperative atrial fibrillation was significantly higher in the statin compared with the no statin group (411, 19.5%, versus 336; 15.8% respectively; p = 0.002). In a multivariate regression analysis, age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), pulmonary disease (OR, 1.42; 95% CI, 1.12-1.82), history of paroxysmal atrial fibrillation (OR, 3; 95% CI, 2.13 to 4.19), preoperative angiotensin-converting enzyme inhibitor therapy (OR, 1.26; 95% CI, 1.07 to 1.49), ejection fraction less than 0.30 (OR, 1.71; 95% CI, 1.22 to 2.38), emergency operations (OR, 4.5; 95% CI, 2 to 10.12), and preoperative statin treatment (OR, 1.31; 95% CI, 1.11 to 1.55) were all independent predictors of postoperative atrial fibrillation.


CONCLUSIONS
Preoperative statin is associated with a significantly higher incidence of postoperative atrial fibrillation compared with no statin treatment in patients undergoing isolated coronary artery bypass grafting.
Miceli
Antonio
A
Bristol Heart Institute, Bristol University, Bristol, United Kingdom.
Fino
Carlo
C
Fiorani
Brenno
B
Yeatman
Mark
M
Narayan
Pradeep
P
Angelini
Gianni D
GD
Caputo
Massimo
M
D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors