title: Impact of pre-operative statin use on risk of mortality and early atrial fibrillation after heart transplantation.
abstract: BACKGROUND
  Pre-operative statin use has shown to reduce the incidence of post-operative atrial fibrillation (AF), but not mortality in patients undergoing cardiac surgery. This association, however, has not been examined in a heart transplant (HT) cohort.
  
  
  METHODS
  Adults (≥18 yr) who underwent HT between 1997 and 2007 at the University of Minnesota were retrospectively identified. Primary outcome was 30-d mortality after HT. Secondary outcomes were 30-d incidence of AF and time to all-cause mortality.
  
  
  RESULTS
  Data from 259 patients (mean age 52.0 ± 11.7 yr, 81% males) were analyzed. Total of 133 (51%) patients were on statin pre-operatively at the time of HT and constituted the statin group. During a mean follow-up of 6.7 ± 3.7 yr, 82 (32%) deaths occurred, 21 (8%) of which occurred within 30 d of HT. The incidence of 30-d mortality was not significantly different between the statin and no-statin groups (9% vs. 7%, p = 0.58). Further, cumulative long-term survival after HT was not significantly different between the study groups (log-rank p = 0.49). Pre-transplant statin use did not impact the 30-d incidence of post-transplant AF (16% vs. 19%, p = 0.59).
  
  
  CONCLUSIONS
  Pre-operative statin therapy does not seem to influence the risk of mortality or early post-operative AF after HT. Future large-scale studies are required to validate these preliminary findings.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Balaji
authors.initials: B
authors.lastname: Krishnan
authors.affiliation: Division of Cardiology, Section Heart Failure and Transplant, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA.
authors.forename: Kairav P
authors.initials: KP
authors.lastname: Vakil
authors.affiliation: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Ashwini
authors.initials: A
authors.lastname: Sankar
authors.affiliation: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Duprez
authors.affiliation: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Benditt
mesh_terms: D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: atrial fibrillation; heart transplantation; mortality; statin