title: Effect of preoperative atorvastatin therapy on atrial fibrillation following off-pump coronary artery bypass grafting.
abstract: BACKGROUND
  Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is still the most common postoperative arrhythmic complication. Previous studies report that patients undergoing preoperative statin therapy had a lower incidence of postoperative AF. This study aimed to assess the effect of preoperative atorvastatin therapy on preventing AF following off-pump CABG in a randomized, controlled trial.
  
  
  RESULTS
  The 140 consecutive patients undergoing elective off-pump CABG, without a history of AF or previous statin treatment, were enrolled and randomly assigned to a statin (atorvastatin 20 mg/day, n=71) or a control group (placebo, n=69) starting 7 days preoperatively. The primary endpoint was the occurrence of postoperative AF; secondary endpoints were major adverse in-hospital cardiac and cerebrovascular events and identification of variables predicting postoperative AF. Atorvastatin significantly reduced the incidence of postoperative AF and the postoperative peak C-reactive protein (CRP) level vs placebo (14% vs 34%, P=0.009; 126.5 +/-22.3 vs 145.2 +/-31.6 mg/L, P<0.0001). Logistic regression analysis showed preoperative atorvastatin treatment was an independent factor associated with a significant reduction in postoperative AF (odds ratio (OR) 0.219, P=0.005), whereas a high postoperative CRP level was associated with increased risk (OR 2.011, P=0.013).
  
  
  CONCLUSIONS
  Administration of atorvastatin 20 mg/day, initiated 1 week before elective off-pump CABG and continued in the postoperative period, significantly decreases postoperative AF.
authors.affiliation: Department of Thoracic Cardiovascular Surgery, Tongji Hospital, Tongji University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ji
authors.forename: Yunqing
authors.initials: Y
authors.lastname: Mei
authors.forename: Xisheng
authors.initials: X
authors.lastname: Wang
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Sun
authors.forename: Jing
authors.initials: J
authors.lastname: Feng
authors.forename: Jianzhi
authors.initials: J
authors.lastname: Cai
authors.forename: Shiliang
authors.initials: S
authors.lastname: Xie
authors.forename: Liangjie
authors.initials: L
authors.lastname: Chi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011300:Preoperative Care; D011758:Pyrroles / Q000008:administration & dosage*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin