title: Atorvastatin Reduces the Incidence of Postoperative Atrial Fibrillation in Statin-Naive Patients Undergoing Isolated Heart Valve Surgery: A Double-Blind, Placebo-Controlled Randomized Trial.
abstract: BACKGROUND
  Atorvastatin has been demonstrated to reduce the incidence of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery, but its effect on isolated heart valve surgery is unknown.
  
  
  METHODS
  In a randomized, double-blinded, placebo-controlled trial, 58 patients who underwent isolated heart valve surgery supported by on-pump cardiopulmonary bypass were randomly assigned to receive either placebo (n = 29) or 40 mg of atorvastatin once daily starting 3 days preoperatively and continuing within 5 days postoperatively (n = 29). A continuous monitoring tool and an electrocardiographic Holter monitoring were used for detecting the POAF (Clinical Trial Registration: www.clinicaltrials.gov; Unique Identifier: NTC02084069).
  
  
  RESULTS
  The patients' median age was 49 years, and 67% were female. In all, 6 (21%) and 13 (45%) cases of POAF were observed in the atorvastatin and placebo groups, respectively (P = .050). The duration of AF before re-establishment of sinus rhythm was significantly lower in the atorvastatin group than in the placebo group (median of 70 vs 132 minutes, P = .026). The lengths of intensive care unit and hospital stay were comparable between the groups. The increase in postoperative white blood cell count was significantly lower in the atorvastatin group than in the placebo group (median of 1.5 vs 2.3 × 10(3)/µL, respectively, P = .019). After adjustment, the atorvastatin treatment was associated with a decrease in the risk of developing POAF (odds ratio 0.122, 95% confidence interval 0.027-0.548, P = .006).
  
  
  CONCLUSIONS
  Perioperative treatment with 40 mg of atorvastatin is useful to decrease the incidence of POAF in the statin-naive patients undergoing isolated heart valve surgery.
authors.affiliation: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Dehghani
authors.affiliation: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Kasianzadeh
authors.affiliation: Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran yousefrezaei1986@gmail.com.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Rezaei
authors.affiliation: Department of Medicine, Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Nariman
authors.initials: N
authors.lastname: Sepehrvand
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004311:Double-Blind Method; D015716:Electrocardiography, Ambulatory; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007492:Iran / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010919:Placebos
chemical_list: D000924:Anticholesteremic Agents; D010919:Placebos; D000069059:Atorvastatin
keywords: atorvastatin; atrial fibrillation; cardiopulmonary bypass; heart valve surgery; inflammation