Comparison of the Efficacy of Atorvastatin and Rosuvastatin in Preventing Atrial Fibrillation after Coronary Artery Bypass Grafting: A Double-blind Randomized Comparative Trial

Background: Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by disorganized atrial activity and subsequent mechanical atrial failure. Postoperative AF is a frequent complication of coronary artery bypass grafting (CABG). Although there is evidence of decreased AF after CABG with statin usage, information is scarce regarding a direct comparison between atorvastatin and rosuvastatin. The present study was conducted to compare the efficacy of rosuvastatin and atorvastatin in preventing post-CABG AF. Methods: The present double-blind randomized comparative clinical trial selected CABG candidates with stable ischemic heart disease or acute coronary syndromes. Atorvastatin (40 mg per day) or rosuvastatin (20 mg per day) was prescribed 1 week before surgery, and the outcomes were compared. Results: Two-hundred patients, 100 cases in each group, completed the study. Twenty-five patients in each group were female, and the mean age was 59.30±8.42 years in the rosuvastatin group and 60.13±9.40 years in the atorvastatin group (P=0.513). The frequency of AF was 31% in the atorvastatin group and 27% in the rosuvastatin group (P=0.534). No significant differences existed between the groups concerning the length of hospital and ICU stay (P=0.333 and P=0.161) and in-hospital and 3-month mortality (P=0.315 and P=0.648). A subgroup analysis of only patients with stable ischemic heart disease could not detect a significant difference between the study groups in any of the investigated outcomes. Our logistic regression analysis showed an association only between age and the incidence of AF after CABG (OR, 1.12; 95% CI, 1.05 to 1.20; P<0.01). Conclusion: Rosuvastatin and atorvastatin are similar concerning the prevention of post-CABG AF, but there is a need for future well-designed multicenter studies on this topic.

The Efficacy of Web-Based Multimedia Education of Normal Electrocardiogram in Junior and Senior Medical Students

Introduction: Wide spread availability of internet made the web based education as a real module for training under -graduate medical students. The aim of this study was to evaluate the efficacy of web based multimedia education in normal electrocardiography. Methods: In a semi-experimental study and based on the educational programs of medical students in their inpatient training courses, the normal electrocardiogram selected for web based multimedia education. The materials necessary to teach normal electrocardiogram were provided and multimedia was prepared for installing into computers. Two groups of medical students, 30 in each group in their cardiology service (senior and junior students) were selected. Mean while the intervention group studied the multimedia for an hour and for comparison group classroom - based education was done. At the end of study all students answered to atwenty question questionnaire about normal electrocardiogram. Results: The percentage of correct answers in intervention and comparison groups was 72% and 71% respectively. The prevalence of correct answer for junior students in intervention and comparison group was 68% and 67% respectively. The percentage for senior students was 73% and 75%. Conclusion: Like other studies, this study showed the multimedia training can be as effective as the routine classroom based learning. Web based multimedia education is as efficient as classroom based education and can be used as a suitable alternative to conventional methods of training