Role of preoperative atorvastatin administration in protection against postoperative atrial fibrillation following conventional coronary artery bypass grafting.
Role of preoperative atorvastatin administration in protection against postoperative atrial fibrillation following conventional coronary artery bypass grafting.
复制标题
术前阿托伐他汀给药在预防传统冠状动脉旁路移植术后发生心房颤动中的作用。
DOI：
10.1536/ihj.52.7
复制
发表时间：
2011
影响因子：
1.5
通讯作者：
Liangjie Chi
中科院分区：
文献类型：
--
作者：
Yifeng Sun;Q. Ji;Y. Mei;Xi;Jing Feng;J. Cai;Liangjie Chi
心房颤动（AF）是冠状动脉旁路移植术（CABG）后最常见的心律失常之一。本研究旨在评价术前阿托伐他汀对体外循环冠状动脉旁路移植术（CCABG）术后房颤的影响。100例连续接受择期CCABG的患者，无AF病史或既往他汀类药物治疗，入组并从术前7天开始随机分配至他汀类药物组（阿托伐他汀20 mg/d，n = 49）或对照组（安慰剂，n = 51）。主要终点是术后AF的发生。所有选定患者在术前和术后每24小时评估一次C反应蛋白（CRP）水平，直至出院。与安慰剂相比，阿托伐他汀显著降低了术后AF的发生率和术后CRP峰值水平（18% vs 41%，P = 0.017; 129.3 ± 24.3 mg/L vs 149.3 ± 32.5 mg/L，P < 0.0001）。Kaplan-Meier曲线证实他汀类药物组术后无房颤生存率明显更好（χ（2）= 7.466，P = 0.006）。Logistic回归分析显示，术前阿托伐他汀治疗是术后AF发生率显著降低的独立因素（OR = 0.235，P = 0.007），而术后CRP水平升高与AF发生率增加相关（OR = 2.421，P = 0.015）。术前应用阿托伐他汀可抑制炎症反应，预防体外循环冠状动脉旁路移植术后的房颤。
Atrial fibrillation (AF) is one of the most common postoperative arrhythmias in patients who undergo coronary artery bypass grafting (CABG). The aim of this study was to evaluate the effect of preoperative atorvastatin on postoperative atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass (CCABG). One hundred consecutive patients undergoing elective CCABG, without history of AF or previous statin treatment, were enrolled and randomly assigned to a statin group (atorvastatin 20 mg/d, n = 49) or a control group (placebo, n = 51) starting 7 days preoperatively. The primary endpoint was the occurrence of postoperative AF. C-reactive protein (CRP) levels were assessed in all selected patients before surgery and every 24 hours postoperatively until discharge from hospital. Atorvastatin significantly reduced the incidence of postoperative AF and postoperative peak CRP level versus placebo (18% versus 41%, P = 0.017; 129.3 ± 24.3 mg/L versus 149.3 ± 32.5 mg/L, P < 0.0001). Kaplan-Meier curves confirmed a significantly better postoperative atrial fibrillation-free survival in the statin group (χ(2) = 7.466, P = 0.006). Logistic regression analysis showed preoperative atorvastatin treatment was an independent factor associated with a significant reduction in postoperative AF (OR = 0.235, P = 0.007), whereas high postoperative CRP levels were associated with increased risk (OR = 2.421, P = 0.015). Preoperative atorvastatin administration may inhibit inflammatory reactions to prevent atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass.