title: Impact of High-Dose Statin Pretreatment in Patients with Stable Angina during Off-Pump Coronary Artery Bypass.
abstract: BACKGROUND
  Periprocedural treatment with high-dose statins is known to have cardioprotective and pleiotropic effects, such as anti-thrombotic and anti-inflammatory actions. We aimed to assess the efficacy of high-dose rosuvastatin loading in patients with stable angina undergoing off-pump coronary artery bypass grafting (OPCAB).
  
  
  METHODS
  A total of 142 patients with stable angina who were scheduled to undergo surgical myocardial revascularization were randomized to receive either pre-treatment with 60-mg rosuvastatin (rosuvastatin group, n=71) or no pre-treatment (control group, n=71) before OPCAB. The primary endpoint was the 30-day incidence of major adverse cardiac events (MACEs). The secondary endpoint was the change in the degree of myocardial ischemia as evaluated with creatine kinase-myocardial band (CK-MB) and troponin T (TnT).
  
  
  RESULTS
  There were no significant intergroup differences in preoperative risk factors or operative strategy. MACEs within 30 days after OPCAB occurred in one patient (1.4%) in the rosuvastatin group and four patients (5.6%) in the control group, respectively (p=0.37). Preoperative CK-MB and TnT were not different between the groups. After OPCAB, the mean maximum CK-MB was significantly higher in the control group (rosuvastatin group 10.7±9.75 ng/mL, control group 14.6±12.9 ng/mL, p=0.04). Furthermore, the mean levels of maximum TnT were significantly higher in the control group (rosuvastatin group 0.18±0.16 ng/mL, control group 0.39±0.70 ng/mL, p=0.02).
  
  
  CONCLUSIONS
  Our findings suggest that high-dose rosuvastatin loading before OPCAB surgery did not result in a significant reduction of 30-day MACEs. However, high-dose rosuvastatin reduced myocardial ischemia after OPCAB.
authors.affiliation: Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Korea.
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Youn
authors.forename: Seong-Yong
authors.initials: SY
authors.lastname: Park
authors.forename: Yoohwa
authors.initials: Y
authors.lastname: Hwang
authors.forename: Huyn-Chul
authors.initials: HC
authors.lastname: Joo
authors.forename: Kyung-Jong
authors.initials: KJ
authors.lastname: Yoo