title: Defining the role of perioperative statin treatment in patients after cardiac surgery: A meta-analysis and systematic review of 20 randomized controlled trials.
abstract: BACKGROUND
  Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery.
  
  
  METHODS
  A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs). The primary endpoints included postoperative atrial fibrillation, acute kidney injury and all-cause mortality.
  
  
  RESULTS
  Twenty studies involving 4338 patients were included in the meta-analysis. Among the patients who underwent cardiac surgery, perioperative statin therapy was significantly associated with a decreased risk of postoperative atrial fibrillation (OR: 0.50; P=0.0004), particularly in the subgroup of patients who used atorvastatin and those who underwent isolated coronary artery bypass grafting (CABG) surgery. Moreover, perioperative statin use significantly decreased the length of hospital stay (weighted mean difference (WMD): -0.43; P=0.002). However, no reductions were observed in acute kidney injury, myocardial infarction, postoperative serum creatinine concentration or the length of intensive care unit (ICU) stay.
  
  
  CONCLUSIONS
  Perioperative statin therapy might be promising for the prevention of postoperative atrial fibrillation following cardiac surgery, especially for patients undergoing isolated CABG surgery or atorvastatin administration. Additionally, statin use can decrease the length of the hospital stay.
authors.affiliation: Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yuan
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Jianlin
authors.initials: J
authors.lastname: Du
authors.affiliation: Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: lindazhang8508@hotmail.com.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
mesh_terms: D001281:Atrial Fibrillation / Q000517:prevention & control; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000517:prevention & control; D012380:Role; D020521:Stroke / Q000517:prevention & control; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Acute kidney injury; Atrial fibrillation; Cardiac surgery; Meta-analysis; Statin