title: Prevention of atrial fibrillation and inflammatory response after on-pump coronary artery bypass using different statin dosages: a randomized, controlled trial.
abstract: BACKGROUND
  This randomized controlled trial aimed to evaluate the effects of seven-day preoperative treatment with two different dosages of atorvastatin on the incidence of postoperative atrial fibrillation (POAF) and release of inflammatory markers such as high-sensitive C-reactive protein (hsCRP) and interleukin-6 in patients undergoing elective first-time on-pump coronary artery bypass grafting (CABG).
  
  
  METHODS
  The cohort study comprised 212 consecutive patients, already taking statins, who underwent elective first-time CABG with cardiopulmonary bypass without history of atrial fibrillation (AF). Patients were randomly divided into two groups: those who received atorvastatin 40 mg (TOR40 group, 111 patients) and those who received 80 mg (TOR80 group, 101 patients) once a day for 7 days before the planned operation. The primary endpoint was the incidence of AF. The secondary endpoints were the postoperative variations of inflammatory markers, hospital length of stay, and the incidence of major adverse cardiac and clinical events.
  
  
  RESULTS
  A total of 26 patients (23.6 %) pretreated with atorvastatin 40 mg and 16 (15.8 %) patients pretreated with atorvastatin 80 mg had postoperative AF but the difference did not reach the statistical significance (p = 0.157). Median values of interleukin-6 and hsCRP at 12 and 24 h did not have differences between the two groups. No statistically significant differences in the other secondary endpoints were detected.
  
  
  CONCLUSIONS
  According to our result, 7-day preoperative treatment with a high dose of atorvastatin is associated with a trend to a decrease in the incidence of POAF compared with treatment at a lower dose, although it does not impact on the level of inflammatory markers.
  
  
  BACKGROUND
  European Clinical Trials Database (EudraCT: 2006-005757-30).
authors.affiliation: Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Michele Danilo
authors.initials: MD
authors.lastname: Pierri
authors.affiliation: Division of Postoperative Intensive Care of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Crescenzi
authors.affiliation: Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Zingaro
authors.affiliation: Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Alfonso
authors.affiliation: Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy. filippocapestro@libero.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Capestro
authors.affiliation: Central Analysis Laboratory of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Vitangelo
authors.initials: V
authors.lastname: Scocco
authors.affiliation: Central Analysis Laboratory of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Brugia
authors.affiliation: Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Torracca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin / Q000008:administration & dosage* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D001026:Coronary Artery Bypass / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein; D000069059:Atorvastatin
keywords: Atrial fibrillation; Coronary artery bypass grafting; Inflammatory mediators