Preoperative statin therapy was not associated with decreased incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery, including patients with low ejection fraction, according to a retrospective study in the March issue of the American Heart Journal.
Salim S. Virani, MD, from the section of cardiology, department of medicine, Baylor College of Medicine in Houston, and colleagues noted that atrial fibrillation (AF) after cardiac surgery is associated with significant morbidity. As a result, they undertook the study to investigate whether preoperative statin therapy was associated with decreased incidence of postoperative AF in patients undergoing cardiac surgery, including isolated valve surgery and patients with low ejection fraction (EF).
In a study, the researchers examined 4,044 consecutive patients without history of AF, who underwent cardiac surgeries at St. Luke's Episcopal Hospital in Houston, from Jan. 1, 2003, through April 30, 2006. They assessed postoperative AF by continuous telemetry monitoring during hospitalization for cardiac surgery.
In total, 2,096 patients received preoperative statins. Atrial fibrillation occurred in 1,270 patients (31.4% in both the statin and nonstatin groups).
In multivariate regression analysis, the researchers found these independent predictors of increased risk: patients greater than 65 years old; a history of valvular heart disease; a history of rheumatic disease; a history of pulmonary disease; and New York Heart Association class III/IV. However, the authors noted that the female sex was associated with decreased risk.
The preoperative statin therapy was not associated with decreased risk in the entire cohort or in subgroups undergoing isolated coronary artery bypass grafting, isolated valve surgery, or both, or the subgroup with EF less than 35 percent, according to the researchers.
After propensity score analysis with 867 patients in each group, Virani and colleagues found that preoperative statin therapy was not associated with decreased AF incidence.