Effect of Early Statin Therapy on Risk of Atrial Fibrillation After Coronary Artery Bypass Grafting With or Without Concomitant Valve Surgery

• Published in: The American journal of cardiology 2011-07, Vol.108 (2), p.220-222
• Main Authors: Rader, Florian, MD, MS, Gajulapalli, Rama Dilip, MD, Pasala, Tilak, MD, Einstadter, Douglas, MD, MPH
• Format: Article
• Language: English
• Subjects: Age Factors; Atrial Fibrillation - etiology; Atrial Fibrillation - prevention & control; Biological and medical sciences; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology; Cardiology. Vascular system; Cardiovascular; Coronary Artery Bypass - adverse effects; Coronary heart disease; Drug Administration Schedule; Drug therapy; Female; Heart; Heart surgery; Heart Valves - surgery; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Length of Stay - statistics & numerical data; Logistic Models; Male; Medical sciences; Middle Aged; Postoperative Care; Statins; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.03.028

Statins decrease postoperative atrial fibrillation (AF) if given before cardiac surgery. However, whether early administration of statins after surgery decreases the risk of postoperative AF is unknown. The association of early reinstitution of postoperative statin therapy within 48 hours to the occurrence of postoperative AF was studied in propensity-adjusted analyses of 200 consecutive patients in sinus rhythm who had undergone coronary artery bypass grafting with or without valve surgery. Postoperative AF occurred in 36 patients (18%). Of 52 patients who received a statin early after surgery, 4 (7.7%) developed AF compared to 32 (28%) of 148 patients who did not (p = 0.043). In the propensity-adjusted analyses, early postoperative statin treatment was associated with a significantly lower occurrence of AF (odds ratio 0.39, 95% confidence interval 0.15 to 0.99), irrespective of concomitant β-blocker therapy. The length of stay was shorter for the patients who received early postoperative statins (median 6.1 days, interquartile range 4 to 7, vs 7.8 days, interquartile range 5 to 8; p = 0.0031). In conclusion, of preoperative statin users undergoing coronary artery bypass grafting with or without valve surgery, early postoperative reinstitution of statins was associated with a lower occurrence of postoperative AF and a shorter length of stay. Early postoperative statin therapy might be a feasible and safe method of reducing postoperative AF.