EFFICACY OF STATIN THERAPY IN THE PREVENTION OF ATRIAL FIBRILLATION IN EARLY POSTOPERATIVE PERIOD AFTER CORONARY ARTERY BYPASS GRAFTING

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Abstract


Background: The incidence of the postoperative atrial fibrillation (POAF) after open heart surgery is up to 65%. Statin therapy has shown conflicting data in the prevention of the POAF. Objective: Our aim was еo evaluate the role of statin therapy in the primary prevention of AF after CABG. Methods: Group 1 (n =84) included those patients who received no statin therapy and the Group 2 (n =124) included those patients who did receive statin therapy for at least three days prior to the operation and for all days in the postoperative period. WBC count in different periods after surgery and rate of AF were evaluated. The risk of occurrence of postoperative AF was evaluated using the Cox-regression model and odds ratio. Results: A retrospective analysis of 206 medical records of the patients without pre-existing AF after CABG was performed. The rate of AF was 26% in Group 1 and 6.5 % in Group 2 (p =0.0001). On Day 4 after surgery, WBC count was 11 (9;13) in the first group and 9 (7,6;10,2)×109 e/L in the second group (p =0.000001). «Statin use» and «number of grafts» and were found to be statistically meaningful: p =0.002 and p =0.0125 respectively (χ2=28,3; p <0.001). In accordance with the Cox model of regression, the risk of AF was 0.201 for «statin use»; and 2.099 for «number of grafts». Odds ratio was 0.2 (95% CI 0.08–0.5). Conclusion: Statin therapy prior to and after GABG was found to be an effective method of primary prevention of AF in the early postoperative period.

 

 


O. L. Bokeriya

Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation

Author for correspondence.
Email: soleo2003@gmail.com

Russian Federation

доктор медицинских наук, профессор, главный научный сотрудник отделения хирурги-
ческого лечения интерактивной патологии НЦ ССХ им. А.Н. Бакулева
Адрес: 121552, Москва, Рублёвское ш., д. 135, тел.: +7 (495) 414-77-91

A. A. Akhobekov

Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: alber-t7@mail.ru

Russian Federation

аспирант отделения хирургического лечения интерактивной патологии НЦ ССХ
им. А.Н. Бакулева
Адрес: 121552, Москва, Рублёвское ш., д. 135, тел.: +7 (495) 414-78-23

V. A. Shvarts

Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: shvartz.va@ya.ru

Russian Federation

кандидат медицинских наук, младший научный сотрудник отделения хирургиче-
ского лечения интерактивной патологии НЦ ССХ им. А.Н. Бакулева
Адрес: 121552, Москва, Рублёвское ш., д. 135, тел.: +7 (495) 414-78-94

Z. F. Kudzoeva

Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: zaika210@mail.ru

Russian Federation

младший научный сотрудник отделения хирургического лечения интерактивной пато-
логии НЦ ССХ им. А.Н. Бакулева
Адрес: 121552, Москва, Рублёвское ш., д. 135, тел.: +7 (495) 414-78-23

  1. Mariscalco G., Klersy C., Zanobini M., Banach M., Ferrarese S., Borsani P., Cantore C., Biglioli P., Sala A. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J. Am. Coll. Cardiol. 2004; 43: 742–748.
  2. Mathew J.P, Fontes M.L., Tudor I.C., Ramsay J., Duke P., Mazer C.D., Barash P.G., Hsu P.H., Mangano D.T. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004; 291: 1720–1729.
  3. Archbold R.A., Curzen N.P. Off pump coronary artery bypass graft surgery. The incidence of postoperative atrial fibrillation. Heart. 2003; 89: 1134–1137.
  4. Filatov A.G., Tarashvili E.G. Epidemiology and social significance of atrial fibrillation. Annaly aritmologii = Annals of arrhythmology. 2012;9(2):5–13.
  5. Bokeriya L.A., Zelenikin M.A., Golukhova E.Z., Batov S.M. Cardiac arrhythmias and conduction in the early postoperative period after surgical correction of congenital heart defects in infants. Annaly aritmologii = Annals of arrhythmology. 2012;9(1):24–32.
  6. Melikulov A.Kh., Maglakelidze D.A. Possible mechanisms and strategies for the prevention of atrial fibrillation after open heart surgery. Annaly aritmologii = Annals of arrhythmology. 2012; 9(1):13–19.
  7. Jarett C., Kwame A. Postoperative Atrial Fibrillation: Role of Inflammatory Biomarkers and Use of Colchicine for Its Prevention. Pharmacotherapy. 2014; 34 (11): 1167–1173.
  8. Bokeriya L.A., Shengeliya L.D. Mechanisms of atrial fibrillation: from ideas and hypotheses to effective understanding of the problems. Annaly aritmologii = Annals of arrhythmology. 2014;11(1):5–9. doi: 10.15275/annaritmol.2014.1.1
  9. Bokeriya O.L., Akhobekov A.A. Effectiveness of statins in the prevention of atrial fibrillation after cardiac surgery. Annaly aritmologii = Annals of arrhythmology. 2014;11(1):14–23. doi: 10.15275/annaritmol.2014.1.2.
  10. Hung C.Y., Hsieh Y.C., Huang J.L., Lin C.H., Wu T.J. Statin Therapy for Primary Prevention of Atrial Fibrillation: Guided by CHADS2/CHA2DS2VASc Score. Korean Circ. J. 2014; 44 (4): 205–209.
  11. Zheng H., Xue S., Hu Z.L., Shan J.G., Yang W.G. The use of statins to prevent postoperative atrial fibrillation after coronary artery bypass grafting: a meta analysis of 12 studies. J. Cardiovasc. Pharmacol. 2014; 64 (3): 285–292.
  12. Samadikhah J., Golzari S., Sabermarouf B., Karimzadeh I. Efficacy of Combination Therapy of Statin and Vitamin C in Comparison with Statin in the Prevention of Post CABG Atrial Fibrillation. Adv. Pharm. Bull. 2014; 4 (1): 97–100.
  13. Jacob K.A., Nathoe H.M., Dieleman J.M., van Osch D., Kluin J., van Dijk D. Inflammation in new-onset atrial fibrillation after cardiac surgery: a systematic review. Eur. J. Clin. Invest. 2014; 44 (4): 402–428. doi: 10.1111/eci.12237.
  14. Gibson P.H., Cuthbertson B.H., Rae D., El-Shafei H., Gibson G., Croal B.L., Jeffrey R.R., Buchan K.G., Hillis G.S. Usefulness of neutrophil/lymphocyte ratio as predictor of new onset atrial fibrillation after coronary artery by pass grafting. Am. J. Cardiol. 2010; 105: 186–191.
  15. Kuhn E.W., Liakopoulos O.J., Stange S., Deppe A.C., Slottosch I., Choi Y.H., Wahlers T. Preoperative statin therapy in cardiac surgery: a meta-analysis of 90 000 patients. Eur. J. Cardiothorac. Surg. 2014; 45 (1): 17–26. doi: 10.1093/ejcts/ezt181.
  16. Lamm G., Auer J., Weber T., Berent R., Ng C., Eber B. Postoperative white blood cell count predicts atrial fibrillation after cardiac surgery. J. Cardiothorac. Vasc. Anesth. 2006; 20: 51–56.
  17. Chello M., Anselmi A., Spadaccio C., Patti G., Goffredo C., Di Sciascio G., Covino E. Simvastatin increases neutrophil apoptosis and reduces inflammatory reaction after coronary surgery. Ann. Thorac. Surg. 2007; 83: 1374–1380.
  18. Kimura M., Kurose I., Russell J., Granger D.N. Effects of fluvastatin on leukocyte — endothelial cell adhesion in hypercholesterolemic rats. Arterioscler .Thromb. Vasc. Biol. 1997; 17 (8): 1521–1526. doi: 10.1161/01.ATV.17.8.1521.
  19. Scalia R., Gooszen M.E., Jones S.P. Simvastatin exers both anti-inflamatory and cardioprotective effects in apolipoprotein E deficient mice. Circulation. 2001; 103 (21): 2598–2603. doi: 10.1161/01.CIR.103.21.2598.
  20. Ikeda U., Shimada K. Statin and monocytes. Lancet. 1999; 353 (9169): 2070. doi: 10.1016/S0140-6736(05)77885-5.
  21. Marin F., Pascual D.A., Roldán V., Arribas J.M., Ahumada M., Tornel P.L. et al. Statins and postoperative risk of atrial fibrillation following coronary artery bypass grafting. Am. J. Cardiol. 2006; 97: 55–60. doi: 10.1016/j.amjcard.2005.07.124.

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