Michele Danilo Pierri1, Giuseppe Crescenzi2, Carlo Zingaro1, Alessandro D'Alfonso1, Filippo Capestro3, Vitangelo Scocco4, Marina Brugia4, Lucia Torracca1. 1. Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy. 2. Division of Postoperative Intensive Care of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy. 3. Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy. filippocapestro@libero.it. 4. Central Analysis Laboratory of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
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. CLINICAL TRIAL REGISTRATION: European Clinical Trials Database (EudraCT: 2006-005757-30).
RCT Entities:
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. CLINICAL TRIAL REGISTRATION: European Clinical Trials Database (EudraCT: 2006-005757-30).
Authors: Scott Kinlay; Gregory G Schwartz; Anders G Olsson; Nader Rifai; Sally J Leslie; William J Sasiela; Michael Szarek; Peter Libby; Peter Ganz Journal: Circulation Date: 2003-09-15 Impact factor: 29.690
Authors: Antonios Kourliouros; Ayesha De Souza; Neil Roberts; Anna Marciniak; Athanasios Tsiouris; Oswaldo Valencia; John Camm; Marjan Jahangiri Journal: Ann Thorac Surg Date: 2008-05 Impact factor: 4.330