Impact of High-Intensity Statin on Atrial Fibrillation After Off-Pump Coronary Artery Bypass.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Thoracic and Cardiovascular Surgeon Pub Date : 2024-10-24 DOI:10.1055/a-2447-0020
Yeiwon Lee, Yoonjin Kang, Ji Seong Kim, Sue Hyun Kim, Suk Ho Sohn, Ho Young Hwang
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Abstract

Background: There is uncertainty regarding the impact of high-intensity statins on postoperative outcomes in patients undergoing surgical myocardial revascularization. This study was conducted to evaluate the impact of high-intensity statin treatment on the occurrence rate of new-onset postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCAB).

Methods: Six hundred thirteen patients (66.8±9.8 years, male:female = 476:137) who underwent isolated OPCAB were retrospectively enrolled. Hypertension (n = 409, 66.7%), diabetes mellitus (n = 343, 59.6%) and chronic kidney disease (n = 138, 22.5%) were common comorbidities. Statins and beta-blockers were administered to all patients until the day of surgery and resumed within 6 hours after surgery. Risk factors associated with POAF were analyzed, including the use of high-intensity statins (atorvastatin 40 mg-80 mg or rosuvastatin 20 mg), as well as baseline characteristics and preoperative risk factors.

Results: High-intensity statins were used in 158 patients (25.8%). POAF occurred in 184 patients (30.0%). The use of high-intensity statins was not correlated with preoperative levels of low-density lipoprotein (P = 0.135) or high sensitivity C-reactive protein (P = 0.365). Multivariate logistic regression analysis revealed that the use of high-intensity statins was significantly associated with a reduced occurrence of POAF (P = 0.022, odds ratio [95% confidence interval] = 0.592 [0.378-0.926]). Age, acute coronary syndrome, insulin-dependent diabetes mellitus and chronic kidney disease were also significantly associated with POAF.

Conclusion: Preoperative administration of high-intensity statins was associated with a 41% reduction in the occurrence rate of POAF in patients who underwent OPCAB.

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高强度他汀对体外循环冠状动脉搭桥术后心房颤动的影响
背景:高强度他汀类药物对接受外科心肌血运重建术的患者术后预后的影响尚不确定。本研究旨在评估高强度他汀治疗对体外循环冠状动脉搭桥术(OPCAB)术后新发心房颤动(POAF)发生率的影响:回顾性纳入了6130名接受分离式OPCAB手术的患者(66.8±9.8岁,男女比例为476:137)。高血压(409 人,66.7%)、糖尿病(343 人,59.6%)和慢性肾病(138 人,22.5%)是常见的合并症。所有患者在手术前都服用了他汀类药物和β-受体阻滞剂,并在术后6小时内恢复服用。分析了与POAF相关的风险因素,包括高强度他汀类药物(阿托伐他汀40毫克-80毫克或罗伐他汀20毫克)的使用情况,以及基线特征和术前风险因素:158名患者(25.8%)使用了高强度他汀类药物。184名患者(30.0%)发生了POAF。高强度他汀类药物的使用与术前低密度脂蛋白(P = 0.135)或高敏C反应蛋白(P = 0.365)的水平无关。多变量逻辑回归分析显示,使用高强度他汀类药物与POAF发生率降低显著相关(P = 0.022,几率比[95%置信区间] = 0.592 [0.378-0.926])。年龄、急性冠状动脉综合征、胰岛素依赖型糖尿病和慢性肾病也与 POAF 有显著相关性:结论:术前服用高强度他汀类药物与OPCAB患者POAF发生率降低41%有关。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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