Sun Yi-feng, Mei Yun-qing, Ji Qiang, Wang Xi-sheng, Feng Jing, Cai Jian-zhi, Zhou Yong-xin, Xie Shi-liang
Department of Thoracic Cardiothoracic Surgery, Tongji Hospital, Tongji University, Shanghai, China.
Zhonghua Yi Xue Za Zhi. 2009 Nov 17;89(42):2988-91.
To evaluate the effect of atorvastatin on postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG).
A cohort of 140 consecutive patients without a history of documented AF or previous statin use, who were scheduled to undergo selective CABG, were enrolled. Included patients were randomly assigned to atorvastatin group (n = 71) who were administered atorvastatin 20 mg/d or to control group (n = 69). After CABG, subjects were monitored continuously by electrocardiographic monitors at least 7 days. During the initial postoperative 7 d, the incidence and duration of AF were recorded. And the levels of high-sensitivity C-reactive protein (hs-CRP) were measured before and 24 hours, 72 hours, 7 days after operation, respectively. The statistical software package SPSS (version 13.0) were used to analyze the data. The differences between groups were evaluated by chi(2)-test for discrete variables and student t-test for continuous variables. Multivariate logistic regression analysis was performed to determine the independent predictors of early postoperative AF.
During initial postoperative 7 d, AF occurred at least once in 10 cases in atorvastatin group, with a prevalence of roughly 14%, and in 23 cases in control group, with a prevalence of approximately 34% (P = 0.009). The mean duration of single AF was 3.6 +/- 0.4 hours in atorvastatin group and 5.7 +/- 0.5 hours in control group (P < 0.01), respectively. The multivariate logistic analysis showed that perioperative atorvastatin administration was an independently risk factor for early postoperative AF (OR = 0.219, 0.076-0.633, P = 0.005). There was also statistical difference in hs-CRP after CABG between the two groups.
Perioperative atorvastatin administration may inhibit inflammatory reaction, reduce the incidence and duration of postoperative AF, hence may prevent and treat postoperative AF.
评估阿托伐他汀对接受冠状动脉旁路移植术（CABG）患者术后房颤（AF）的影响。
纳入140例连续的计划接受选择性CABG且无房颤病史或未使用过他汀类药物的患者。将纳入患者随机分为阿托伐他汀组（n = 71），给予阿托伐他汀20 mg/d，或对照组（n = 69）。CABG术后，通过心电图监护仪对受试者进行至少7天的连续监测。在术后最初7天内，记录房颤的发生率和持续时间。分别在手术前、术后24小时、72小时、7天测量高敏C反应蛋白（hs-CRP）水平。使用统计软件包SPSS（版本13.0）分析数据。组间差异通过离散变量的卡方检验和连续变量的学生t检验进行评估。进行多因素逻辑回归分析以确定术后早期房颤的独立预测因素。
术后最初7天内，阿托伐他汀组有10例至少发生1次房颤，发生率约为14%，对照组有23例，发生率约为34%（P = 0.009）。阿托伐他汀组单次房颤的平均持续时间为3.6±0.4小时，对照组为5.7±0.5小时（P < 0.01）。多因素逻辑分析表明，围手术期给予阿托伐他汀是术后早期房颤的独立危险因素（OR = 0.219，0.076 - 0.633，P = 0.005）。两组CABG术后hs-CRP也存在统计学差异。
围手术期给予阿托伐他汀可能抑制炎症反应，降低术后房颤的发生率和持续时间，从而可能预防和治疗术后房颤。
