Cor Vasa 2017, 59(3):e266-e271 | DOI: 10.1016/j.crvasa.2016.11.003

Statin therapy in the prevention of atrial fibrillation in the early postoperative period after coronary artery bypass grafting: A meta-analysis

Olga L. Bockeria^a,*, Vladimir A. Shvartz^a, Albert A. Akhobekov^a, Ludmila A. Glushko^a, Tatayna G. Le^a, Anton R. Kiselev^a, Mikhail D. Prokhorov^b, Leo A. Bockeria^a

^a Department of Surgical Treatment for Interactive Pathology, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

^b Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia

Background: Postoperative atrial fibrillation (POAF) is observed in the early postoperative period in approximately every third patient after coronary artery bypass grafting (CABG). The pathogenesis of POAF is multifactorial and is not yet fully studied. In many studies, post-operative inflammatory response has been extensively investigated as a potential basic factor of POAF. It is known that statins have anti-inflammatory properties. In some studies, pre- and perioperative use of statins has shown the decrease of incidence of POAF after CABG.

Objective: We conducted meta-analysis of randomized and observational studies of efficiency of statin therapy for the prevention of POAF after CABG.

Material and methods: The meta-analysis included 15 clinical trials of statins in 9369 patients with performed CABG during the past 10 years. 5598 patients (59.75%) were taking statins and 3771 patients (40.25%) were not taking statins. The following outcomes observed in the early postoperative period were studied: incidence of POAF, total mortality rate, and total stroke rate, total rate of myocardial infarction. The duration of hospitalization and levels of inflammatory markers before and after CABG were also assessed.

Results: The statin therapy reduced the incidence of POAF after CABG (OR = 0.48, 95% CI: 0.35-0.67, p < 0.001). Moreover, the statin therapy decreased the total length of hospital stay and levels of inflammatory markers in the blood serum.

Conclusion: The results of our meta-analysis leave no doubt in the presence of anti-inflammatory and anti-arrhythmic effect of statin therapy. We confirmed the overall positive role of using statins before CABG for POAF prevention.

Keywords: Atrial fibrillation; Coronary artery bypass grafting,; Statin therapy

Received: April 21, 2016; Revised: November 3, 2016; Accepted: November 3, 2016; Published: June 1, 2017  Show citation