title: The effect of a high dose of atorvastatin on the occurrence of atrial fibrillation after coronary artery bypass grafting.
abstract: BACKGROUND
  Recent studies have suggested that statins reduce the incidence of atrial fibrillation (AF) after cardiac operations. Statin therapy at intensive doses, however, has yet to be thoroughly investigated.
  
  
  METHODS
  We retrospectively studied 1,839 consecutive patients (1,177 men [73.2%]) who underwent isolated coronary artery bypass grafting and had no history of previous AF, pacemaker implantation, or antiarrhythmic medication. Data recorded included the atorvastatin dose during hospitalization, demographic, echocardiographic, and angiographic data, medical history, drug treatment, and procedural characteristics. Continuous telemonitoring during the first 72 postoperative hours assessed for AF, which was defined as episodes lasting more than 5 minutes. The dose-related effect of atorvastatin on postoperative AF was investigated by logistic analysis in 1,607 patients: 75 (4.7%) did not receive atorvastatin vs 1,047 (65.1%) and 485 (30.2%) who received 40 mg/d or 80 mg/d, respectively, for at least 3 days before the operation.
  
  
  RESULTS
  The study population was a mean age of 60.6 ± 9.5 years. Multivariate logistic regression demonstrated that a lack of atorvastatin pretreatment along with older age, enlarged left atrium, and male sex, and not taking β-blockers, tended to be associated with an increased risk of postoperative AF. There was no significant difference between the effect of a higher (80 mg/d) and a lower dose (40 mg/d) in reducing postoperative AF.
  
  
  CONCLUSIONS
  Atorvastatin pretreatment significantly reduced the occurrence of AF after bypass grafting; nonetheless, the difference between the beneficial effects of intensive and routine atorvastatin treatments on postoperative AF was not significant.
authors.affiliation: Cardiac Surgery Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abasali
authors.initials: A
authors.lastname: Karimi
authors.forename: Leila Mohammadi
authors.initials: LM
authors.lastname: Bidhendi
authors.forename: Mehrnaz
authors.initials: M
authors.lastname: Rezvanfard
authors.forename: Payvand
authors.initials: P
authors.lastname: Bina
authors.forename: Arezou
authors.initials: A
authors.lastname: Yousefi
authors.forename: Maliheh
authors.initials: M
authors.lastname: Molai
authors.forename: Elmira
authors.initials: E
authors.lastname: Zare
authors.forename: Mahmood Sheikh
authors.initials: MS
authors.lastname: Fathollahi
authors.forename: Saeed
authors.initials: S
authors.lastname: Sadeghian
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin