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This Article Full Text Full Text (PDF) CME: Take the activity for this article: Dose-Related Effect of Statins on Atr... Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Neil Roberts Marjan Jahangiri Permission Requests Citing Articles Citing Articles via HighWire Google Scholar Articles by Kourliouros, A. Articles by Jahangiri, M. PubMed Articles by Kourliouros, A. Articles by Jahangiri, M. Related Collections Electrophysiology - arrhythmias Related Article

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Original Articles: Adult Cardiac

Dose-Related Effect of Statins on Atrial Fibrillation After Cardiac Surgery

^a Department of Cardiothoracic Surgery, St. George's Hospital, London, United Kingdom
^b Department of Cardiac and Vascular Sciences, St. George's University of London, London, United Kingdom

Accepted for publication January 11, 2008.

^_* Address correspondence to Prof Jahangiri, Department of Cardiac Surgery, St. George's Hospital, Blackshaw Rd, London, SW17 0QT, United Kingdom (Email: marjan.jahangiri{at}stgeorges.nhs.uk).

Background: Atrial fibrillation (AF) is the most common heart rhythm abnormality after cardiac surgery. It increases morbidity and prolongs hospital stay. A role for statins in the prevention of AF has been suggested. We hypothesized that the incidence of postoperative AF due to statin therapy is dose-related.

Methods: A retrospective study of 680 consecutive patients undergoing coronary bypass graft surgery and/or aortic valve replacement was done. Excluded were 57 patients (8.4%) with history of AF, permanent pacemakers, and those receiving antiarrhythmic medication. Preoperative statin treatment and occurrence of postoperative AF were examined using propensity score matching to adjust for differences in patient characteristics between the statin and no-statin groups.

Results: The cohort comprised 623 patients. The statin group had a 27.1% incidence of postoperative AF vs 38.3% in the no-statin group (adjusted odds ratio [OR], 2.00; 95% confidence interval, 1.24 to 3.24; p = 0.004). Simvastatin (40 mg) and atorvastatin (40 mg) demonstrated the greatest effect on postoperative AF at 15.6% and 21.2%, respectively, vs no statins (respective adjusted ORs, 3.89 [p < 0.0001] and 2.76 [p = 0.012]). Intermediate-dose (20 mg) statins were also effective against AF, at 24.4% for simvastatin (adjusted OR, 2.32; p = 0.004) and 26.4% for atorvastatin (adjusted OR, 1.99, p = 0.047). Low-dose statins, simvastatin or atorvastatin (10 mg), did not influence postoperative AF.

Conclusions: Statin treatment may reduce the incidence of AF after cardiac surgery. Higher-dose statins have the greatest preventative effect, whereas low-dose statins do not influence postoperative AF.

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