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Prevention of atrial fibrillation and inflammatory response after on-pump coronary artery bypass using different statin dosages: a randomized, controlled trial

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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).

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Acknowledgments

No other persons have made substantial contributions to this manuscript.

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Authors and Affiliations

  1. Division of Cardiac Surgery of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy

    Michele Danilo Pierri, Carlo Zingaro, Alessandro D’Alfonso, Filippo Capestro & Lucia Torracca

  2. Division of Postoperative Intensive Care of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy

    Giuseppe Crescenzi

  3. Central Analysis Laboratory of Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy

    Vitangelo Scocco & Marina Brugia

Authors
  1. Michele Danilo Pierri
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  2. Giuseppe Crescenzi
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  3. Carlo Zingaro
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  4. Alessandro D’Alfonso
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  5. Filippo Capestro
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  6. Vitangelo Scocco
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  7. Marina Brugia
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  8. Lucia Torracca
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Corresponding author

Correspondence to Filippo Capestro.

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Conflict of interest

Michele Danilo Pierri and other authors have no conflict of interest.

Funding sources

This study was supported by grants (drugs and technical support) of Pfizer Italia Srl.

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Pierri, M., Crescenzi, G., Zingaro, C. et al. Prevention of atrial fibrillation and inflammatory response after on-pump coronary artery bypass using different statin dosages: a randomized, controlled trial. Gen Thorac Cardiovasc Surg 64, 395–402 (2016). https://doi.org/10.1007/s11748-016-0647-y

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  • DOI: https://doi.org/10.1007/s11748-016-0647-y

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