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他汀类药物对预防心脏手术后房颤的作用

Effect of Statins in Preventing Postoperative Atrial Fibrillation Following Cardiac Surgery.

作者信息

Yin Liang, Wang Zhinong, Wang Yifeng, Ji Guangyu, Xu Zhiyun

机构信息

Cardiothoracic surgery department of Changhai Hospital, the First Affiliated Hospital of the Second Military Medical University of PLA, Shanghai 200433, China.

出版信息

J Atr Fibrillation. 2010 Mar 1;2(5):214. doi: 10.4022/jafib.214. eCollection 2010 Mar-May.

Abstract

Postoperative occurrence of AF has been associated with less favorable outcomes in patients undergoing cardiac surgery and may result in increased postoperative morbidity and mortality. A focused clinical question was designed and a Meta-analysis of published studies was performed to identify the effect of preoperative use of statins on the occurrence of AF after cardiac surgery. Using the Medline database, the Cochrane clinical trials database and online clinical trial databases, we reviewed all RCTs and observational studies examining the effect of statins on AF occurrence following cardiac surgery. We searched for literature published before April 2009 and earlier. This analysis identified 6 studies (observational studies) which examined the effect of preoperative use of statins on AF occurrence following cardiac surgery, involving 10165 patients. Contradictory to most of previous studies, the overall outcomes suggested that the statins group did not have a significant decrease in AF occurrence following cardiac surgery comparing to control group (P = 0.19). The preoperative medication of statins showed no significant decrease in AF occurrence following cardiac surgery in this Meta-analysis result. More prospective studies and researches are needed to explore and demonstrate the accurate mechanism and effect of statins on postoperative AF.

摘要

心脏手术患者术后发生房颤与预后较差相关,可能导致术后发病率和死亡率增加。设计了一个重点临床问题,并对已发表的研究进行了荟萃分析,以确定术前使用他汀类药物对心脏手术后房颤发生的影响。通过检索Medline数据库、Cochrane临床试验数据库和在线临床试验数据库,我们回顾了所有研究他汀类药物对心脏手术后房颤发生影响的随机对照试验(RCT)和观察性研究。我们搜索了2009年4月及更早之前发表的文献。该分析确定了6项(观察性研究)研究术前使用他汀类药物对心脏手术后房颤发生影响的研究,涉及10165例患者。与大多数先前的研究相反,总体结果表明,与对照组相比,他汀类药物组在心脏手术后房颤发生率没有显著降低(P = 0.19)。该荟萃分析结果显示,术前使用他汀类药物在心脏手术后房颤发生率方面没有显著降低。需要更多的前瞻性研究来探索和证明他汀类药物对术后房颤的确切机制和影响。

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Preoperative statin therapy for patients undergoing cardiac surgery.心脏手术患者的术前他汀类药物治疗。
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本文引用的文献

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Postoperative atrial fibrillation - what do we really know?术后心房颤动——我们究竟了解多少?
Curr Vasc Pharmacol. 2010 Jul;8(4):553-72. doi: 10.2174/157016110791330807.

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