Effects of perioperative statin treatment on postoperative atrial fibrillation and cardiac mortality in patients undergoing coronary artery bypass grafting: a propensity score analysis.
OBJECTIVE
To evaluate the effect of perioperative statin treatment on postoperative atrial fibrillation and cardiac mortality in patients undergoing coronary artery bypass grafting.


METHODS
A total of 1890 patients who underwent isolated coronary artery bypass were analyzed retrospectively, of which 425 patients (22.4%) older than 70 were included in the study. The demographic properties, preoperative, operative and postoperative data and other medications of these patients were recorded. Continuous preoperative and postoperative atorvastatin therapy were received by 124 (29.17%) patients; 301 (70.82%) patients were matched to a control group (no-statin group). The two groups were matched by propensity score analysis in terms of atrial fibrillation development and cardiac mortality.


RESULTS
Medical history, medical treatment, cardiovascular history, and operative characteristics demonstrated significant heterogeneity in both groups. Postoperative atrial fibrillation was similar in both groups. Before propensity score matching, the percentages of patients in postoperative atrial fibrillation with respect to Atorvastain-group and No-statin-group were 13.71 and 10.3 respectively; however, those were 13.71 and 14.51 after matching. In a multivariate regression analysis, five-vessel bypass (odds ratio OR, 2.354; 95% confidence interval CI, 0.99 to 5.57) was an independent predictor of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. In-hospital mortality was higher in the Atorvastatin-group compared with the No-statin-group: 124 (8.9%) versus 301 (3.7%), respectively; p=0.027).


CONCLUSIONS
Perioperative atorvastatin treatment is not found to be associated with reduced postoperative atrial fibrillation and cardiac mortality in patients undergoing isolated coronary artery bypass grafting above the age of seventy years.
Department of Cardiovascular Surgery, School of Medicine, 100.Yil University, Van; Turkey.
Ayşegül
A
Kunt
Department of Cardiovascular Surgery, School of Medicine, 18 Mart University, Çanakkale; Turkey.
Sedat
S
Özcan
Department of Cardiac Surgery, Ataturk Education and Research Hospital, Ankara; Turkey.
Aslihan
A
Küçüker
Department of Cardiovascular Surgery, School of Medicine, 100.Yil University, Van; Turkey.
Dolunay
D
Odabaşi
Department of Cardiovascular Surgery, School of Medicine, 100.Yil University, Van; Turkey.
Alper
A
Sami Kunt
D000368:Aged; D000069059:Atorvastatin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001026:Coronary Artery Bypass; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality*; D057216:Propensity Score; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin
cardiac mortality; coronary artery bypass grafting; postoperative atrial fibrillation; preoperative statin therapy; propensity score analysis