1 research outputs found
Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials
Aims Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF).
However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine
anti-arrhythmic benefits of these agents in this setting.We therefore aimed to quantify precisely the association between
statin pretreatment and postoperative AF among patients undergoing cardiac surgery.
Methods
and results
A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012)was conducted, followed by a
review of the reference lists of published studies and correspondence with trial investigators to obtain individual–
participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared
the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before
elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting ≥5 min. Overall, 1105 participants from
11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these
participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval
0.31–0.54, P , 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatmentwas consistent
across different subgroups.
Conclusion Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery