Ege Erdal, Dereli Yüksel, Kurban Sevil, Sarigül Ali
Selçuk University, Meram Medical School, Department of Cardiovascular Surgery, Konya, Turkey.
J Cardiothorac Surg. 2010 Aug 13;5:60. doi: 10.1186/1749-8090-5-60.
Statin pretreatment has been associated with a decrease in myocardial ischemia markers after various procedures and cardiovascular events. This study examined the potential beneficial effects of preoperative atorvastatin treatment among patients undergoing on-pump CABG operation.
Twenty patients that had received atorvastatin treatment for at least 15 days prior to the operation and 20 patients who had not received any antihyperlipidemic agent prior to surgery were included in this study. CK-MB and troponin I levels were measured at baseline and 24 hours after the operation. Perioperative variables were also recorded.
Twenty-four hours after the operation, troponin I and CK-MB levels were significantly lower in the atorvastatin group: for CK-MB levels, 12.9 +/- 4.3 versus 18.7 +/- 7.4 ng/ml, p = 0.004; for troponin I levels, 1.7 +/- 0.3 versus 2.7 +/- 0.7 ng/ml, p < 0.001. In addition, atorvastatin use was associated with a decrease in the duration of ICU stay.
Preoperative atorvastatin treatment results in significant reductions in the levels of myocardial injury markers early after on-pump CABG operation, suggesting a reduction in perioperative ischemia in this group of patients. Further studies are needed to elucidate the mechanisms of these potential benefits of statin pretreatment.
他汀类药物预处理与各种手术及心血管事件后心肌缺血标志物的降低有关。本研究探讨了术前阿托伐他汀治疗对接受体外循环冠状动脉旁路移植术(CABG)患者的潜在益处。
本研究纳入了20例术前至少接受15天阿托伐他汀治疗的患者和20例术前未接受任何抗高脂血症药物治疗的患者。在基线和术后24小时测量肌酸激酶同工酶(CK-MB)和肌钙蛋白I水平。同时记录围手术期变量。
术后24小时,阿托伐他汀组的肌钙蛋白I和CK-MB水平显著降低:CK-MB水平,分别为12.9±4.3与18.7±7.4 ng/ml,p = 0.004;肌钙蛋白I水平,分别为1.7±0.3与2.7±0.7 ng/ml,p < 0.001。此外,使用阿托伐他汀与重症监护病房(ICU)住院时间缩短有关。
术前阿托伐他汀治疗可使体外循环CABG术后早期心肌损伤标志物水平显著降低,提示该组患者围手术期缺血减少。需要进一步研究以阐明他汀类药物预处理这些潜在益处的机制。