Literature DB >> 26828081

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Ufuk Aydın, Yusuf Ata, Tamer Türk.   

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Year:  2015        PMID: 26828081      PMCID: PMC5336989     

Source DB:  PubMed          Journal:  Anatol J Cardiol        ISSN: 2149-2263            Impact factor:   1.596


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To the Editor, We thank the authors for their comments on our article entitled “Efficiency of postoperative statin treatment for preventing new onset postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting: a prospective randomized study” published in Anatol J Cardiol 2015; 15: 491-5 (1). Our prospective and randomized study with a statin therapy regimen in the early postoperative period showed a statistically significant decrease in postoperative new-onset AF and a significant decrease in CRP levels in patients undergoing isolated CABG (1). Preoperative statin therapy is also shown to reduce the incidence of postoperative AF (2, 3). ARMYDA-3 was the first randomized, controlled trial to evaluate the impact of preoperative statin therapy on postoperative AF. In that study, the peak CRP levels were not different between the placebo and atorvastatin groups, but preoperative atorvastatin reduced the risk of postoperative AF (2). Recent studies have shown that statins reduce the CRP level in 2 weeks (4). Sakamoto et al. (3) started statin therapy in the preoperative period and showed that statins reduce the CRP level in the 7th postoperative day. The largest study is a systematic review of 91491 patients who showed a reduction in postoperative AF with preoperative statin therapy. In conclusion, preoperative statin therapy in patients undergoing elective cardiac surgery is associated with reduced levels of inflammatory markers postoperatively (5). Sakamoto et al. (3) detected a delay of approximately 2 days in the occurrence of AF in patients with preoperative statin therapy compared with those without statin therapy. This fact is meaningful for postoperative care as it indicates that preoperative statin therapy can avoid AF development in unstable hemodynamics immediately after surgery. Recently, CABG is frequently performed on the day after coronary angiography; therefore, preoperative statin therapy cannot be administered in most patients. The patients did not have preoperative statin therapy in our study, and we did not detect any difference in the occurrence day of the first postoperative AF. Therefore, we suggest that statin therapy should be preoperatively started if available (1). Moreover, other mechanisms might contribute to the clinical benefit of statins such as antioxidant effects, direct antiarrhythmic effects by cell membrane ion channel stabilization, improvement of coronary flow velocity reserve by vasodilation of coronary microvessels, rapid (<12 h after a single dose of atorvastatin) improvement of endothelial function, or direct protection of the myocardium and might also play a role in extracellular matrix modulation (3, 4). These effects might contribute to the prevention of atrial fibrillation of statins. In light of our study results, we suggest that if preoperative statin therapy is not administered to patients, statin therapy should be started in a short time postoperatively to obtain the beneficial effects of statins.
  5 in total

1.  Do preoperative statins reduce atrial fibrillation after coronary artery bypass grafting?

Authors:  Hiroaki Sakamoto; Yasunori Watanabe; Masataka Satou
Journal:  Ann Thorac Cardiovasc Surg       Date:  2011       Impact factor: 1.520

2.  Clinical benefit of statin pretreatment in patients undergoing percutaneous coronary intervention: a collaborative patient-level meta-analysis of 13 randomized studies.

Authors:  Giuseppe Patti; Christopher P Cannon; Sabina A Murphy; Simona Mega; Vincenzo Pasceri; Carlo Briguori; Antonio Colombo; Kyeong Ho Yun; Myung Ho Jeong; Jung-Sun Kim; Donghoon Choi; Huseyin Bozbas; Masayoshi Kinoshita; Keiichi Fukuda; Xin-Wei Jia; Hidehiko Hara; Serkan Cay; Germano Di Sciascio
Journal:  Circulation       Date:  2011-04-04       Impact factor: 29.690

3.  Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study.

Authors:  Giuseppe Patti; Massimo Chello; Dario Candura; Vincenzo Pasceri; Andrea D'Ambrosio; Elvio Covino; Germano Di Sciascio
Journal:  Circulation       Date:  2006-09-25       Impact factor: 29.690

Review 4.  Does preoperative statin therapy prevent postoperative atrial fibrillation in patients undergoing cardiac surgery?

Authors:  Sean L Goh; Kok H Yap; Kim C Chua; Victor T T Chao
Journal:  Interact Cardiovasc Thorac Surg       Date:  2014-12-04

5.  Efficiency of postoperative statin treatment for preventing new-onset postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting: A prospective randomized study.

Authors:  Ufuk Aydın; Mehmet Yılmaz; Çağrı Düzyol; Yusuf Ata; Tamer Türk; Ahmet Lütfullah Orhan; Cevdet Uğur Koçoğulları
Journal:  Anatol J Cardiol       Date:  2014-06-03       Impact factor: 1.596

  5 in total

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