Effect of Statins on the Incidence of Postoperative Atrial Fibrillation after Cardiac Valve Surgery

Abstract

Preoperative statin use was not associated with a decreased incidence of POAF in patients undergoing isolated cardiac valve surgery. Additional studies are needed to further elucidate the pharmacodynamics of statins in patients undergoing cardiac surgery because statins have demonstrated a decrease in the risk of POAF in other cardiac surgery populations.

Do Statins Attenuate Postoperative Atrial Fibrillation in Isolated Heart Valve Surgery?

“…We appreciate the comments by Rezaei and colleagues regarding our study of the effect of preoperative statin use on postoperative atrial fibrillation (POAF) in patients undergoing isolated cardiac valve surgery . As they point out, our study was not without limitations, many of which are a common theme in observational studies into the effect of statins on POAF.…”

“…We read with great interest the article by Bolesta and Kong on the effect of statins on POAF in patients undergoing isolated heart valve surgeries. The authors noted that preoperative statin use, defined as receiving at least one dose of a statin within 24 hours before surgery, did not reduce POAF incidence compared to those not receiving a statin (34.3% vs 27.5%; p=NS).…”

“…In a latest meta‐analysis, it was shown that atorvastatin was more effective than other statins in the prevention of POAF after cardiac surgeries, although there were insufficient data to provide evidence in the setting of isolated valvular surgeries . Most of the studies of patients undergoing isolated heart valve surgeries that have demonstrated the inefficacy of statins in the prevention of POAF have been retrospective . However, in a recently published randomized study―the only evidence of a randomized study in this background―preoperative atorvastatin (40 mg) reduced POAF incidence in patients undergoing isolated heart valve surgeries compared with those receiving placebo, with a number needed to treat of four (21% vs 45%; p=0.05) …”

Statins and atrial fibrillation - mini - review on recent evidence

“…In other types of cardiac surgery, such as isolated cardiac valve surgery, Bolesta and Kong (2015) indicated that pre-operative statin use was not associated with a decreased incidence of POAF. The results of this retrospective study of 244 adults may be associated with the fact that the duration of preoperative statin use and the statin dose were unknown and were not included in the analysis.…”

“…The results of this retrospective study of 244 adults may be associated with the fact that the duration of preoperative statin use and the statin dose were unknown and were not included in the analysis. Moreover, patients after isolated cardiac valve surgery may undergo a different inflammatory and oxidative response than patients after reperfusion surgery (Bolesta and Kong 2015).…”