title: Statins reduce short- and long-term mortality associated with postoperative atrial fibrillation after coronary artery bypass grafting: impact of postoperative atrial fibrillation and statin therapy on survival.
abstract: BACKGROUND
  Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass grafting (CABG) surgery. The objective of this study was to determine the impact of POAF on both short- and long-term mortality following isolated CABG.
  
  
  OBJECTIVE
  POAF is associated with a poorer short and long-term mortality following CABG.
  
  
  METHODS
  We retrospectively analyzed the preoperative and operative data of 6728 consecutive patients undergoing a first isolated CABG.
  
  
  RESULTS
  The incidence of POAF was 27.8%. Operative mortality was higher in patients with POAF compared to those without POAF (2.3% vs 0.9%, P < 0.001). On multivariate analysis, POAF remained an independent predictor of operative mortality (odds ratio [OR]: 1.78, P = 0.01). Patients with POAF also had reduced long-term survival (6-year survival: 85.3% vs 89.2%, P < 0.001). After adjusting for other predictors of mortality, POAF was significantly associated with increased long-term mortality (hazard ratio [HR]: 1.35, P = 0.04). Of note, after adjustment for potential confounders, statin treatment had a highly protective effect in POAF patients for both operative mortality (OR: 0.38, P = 0.003) and long-term mortality (HR: 0.62, P = 0.03), whereas it had no significant effect in patients without POAF.
  
  
  CONCLUSIONS
  POAF is an independent predictor of both short- and long-term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.
authors.affiliation: Department of Surgery, Laval University, Quebec, Canada.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: Pascal
authors.initials: P
authors.lastname: Daleau
authors.forename: Pierre
authors.initials: P
authors.lastname: Voisine
authors.forename: Gilles
authors.initials: G
authors.lastname: O'Hara
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.forename: Patrick
authors.initials: P
authors.lastname: Mathieu
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011792:Quebec; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors