Preoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery

Martínez‐Comendador, José Manuel; Álvarez, José Rubio; Mosquera, Ignacio; Sierra, Juan; Adrio, Belén; Carro, Javier García; Teijeira-Fernández, Elvis; Bengochea, José

doi:10.1016/j.ejcts.2009.05.022

Cited by 46 publications

(31 citation statements)

References 23 publications

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“…24, 34 We did not show that alterations after CPB are clearly seen on the endothelium, the increased amount of IL-6 and TNF-a. But we may declare that by altering the levels and activities of t-PA, IL-8, and PAI-I, statins seem to stimulate fibrinolysis.…”

Section: Discussionmentioning

confidence: 72%

Postoperative Statin Therapy Attenuates the Intensity of Systemic Inflammation and Increases Fibrinolysis After Coronary Artery Bypass Grafting

Tetik

Sahin

et al. 2010

Clin Appl Thromb Hemost

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A total of 25 patients undergoing coronary artery bypass grafting (CABG) were included in the study. Patients received statin (20 mg daily) postoperatively for 2 weeks. All analyses were performed at 2 different time points: preoperatively (group 1) and 2 weeks after operation (group 2). Interleukin (IL)-6, IL-8, plasminogen activator inhibitor 1 (PAI-1), tumor necrosis factor α (TNF-α), tissue plasminogen activator (t-PA) levels, and tissue factor pathway inhibitor (TFPI) were evaluated. Statin treatment caused a significant reduction in the plasma level of PAI-1 (preop: 15.04 ± 0.13 ng/mL vs postop: 13.89 ± 2.14 ng/mL; P < .05) and increased t-PA levels (preop: 109.74 ± 0.13 vs postop: 231.40 ± 1.22 ng/mL; P < .001). Plasma TNF-α and IL-6 levels did not change with treatment. Statin treatment caused a significant reduction in plasma IL-8 level (279.70 ± 3.42 ng/mL vs postop: 207.18 ± 3.63 ng/mL, P < .05), and TFPI (4.87 ± 2.05 ng/mL vs postop: 6.27 ± 1.25 ng/mL; P < .05). The results demonstrate that atorvastatin attenuates systemic inflammatory reaction after cardiac surgery.

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Section: Discussionmentioning

confidence: 72%

Postoperative Statin Therapy Attenuates the Intensity of Systemic Inflammation and Increases Fibrinolysis After Coronary Artery Bypass Grafting

Tetik

Sahin

et al. 2010

Clin Appl Thromb Hemost

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“…Factors influencing the inflammatory response such as bypass time or cross-clamp time did no differ between the different genetic variants (Tables 2 and 3). Furthermore, there was no difference in preoperative statin treatment that influences the inflammatory response according to a recently published study [19].…”

Section: Discussionmentioning

confidence: 88%

Tumor necrosis factor-α –863 C/A promoter polymorphism affects the inflammatory response after cardiac surgery

Boehm¹,

Hauner²,

Grammer³

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…Нами показано, что уровень ИЛ-8 и ИЛ-10 не изменился в ходе реконструктивной операции, что продемонстри-ровано Martínez-Comendador JM (2009). Таким обра-зом, предоперационное использование аторвастатина способствует уменьшению острого воспалительного от-вета, ассоциированного с операцией КШ [13].…”

Section: Discussionunclassified

“…Наши ре-зультаты отличаются от работы Martínez-Comendador J.M. (2009), где автор отметил увеличение уровня тропо-нина в группе больных, принимающих ингибиторы ГМГ-КоА-редуктазы [13].…”

Section: Discussionunclassified

Efficacy of atorvastatin therapy in prevention of postoperative atrial fibrillation in patients with ischemic heart disease

Rubanenko

2015

Racionalʹnaâ farmakoterapiâ v kardiologii

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Фибрилляция предсердий (ФП) при открытых опе-рациях на сердце встречается с частотой от 18 до 40%. Она определяет дальнейший прогноз пациентов с ишемической болезнью сердца (ИБС), поскольку увеличивает риск инсульта, способствует возникнове-нию и прогрессированию сердечной недостаточности [1][2][3]. Патофизиологические механизмы, лежащие в ос-нове развития ФП, активно изучаются. Большинство ис-следований показывают многофакторность послеопе-рационной аритмии [1,4,5]. В последнее время ряд ра-бот подчеркивают важную роль воспаления в возник-новении ФП после коронарного шунтирования (КШ) [1,5]. Ингибиторы 3-гидрокси-3-метилглютарил-коэн-зим А-редуктазы (ГМГ-Коа-редуктазы) -группа пре-паратов, известная своим антиоксидантным и проти-вовоспалительным действием, применяющаяся у па-циентов с ИБС, в том числе при дислипидемиях. Пред-операционное назначение статинов, в том числе в ко-роткие сроки до КШ, способствует уменьшению новых случаев ФП [1,4,5]. Представляется интересным из-учение показателей, провоцирующих развитие нару-шения ритма после реконструктивных операций, на фоне гиполипидемической терапии.Цель исследования: изучить эффективность терапии аторвастатином в профилактике ФП у больных ИБС, под-вергающихся операции КШ, с оценкой факторов вос- Aim. To evaluate the efficacy of atorvastatin therapy in prevention of atrial fibrillation (AF) development after coronary artery bypass graft (CABG) surgery in patients with ischemic heart disease (IHD) with the assessment of inflammation, sheer stress and myocardial injury indicators. Material and methods. The study included 105 patients with IHD who were divided into two groups: patients of group 1 were treated with atorvastatin (59 patients, 81% males, mean age 62.1±7.5 years); patients of group 2 received no HMG-CoA reductase inhibitors (46 patients, 89% males, and mean age 61.7±8.1 years).Results. Postoperative AF occurred more often in patients of group 2 (41.3% vs 16.9%; р=0.047). Laboratory analysis revealed the following: the levels of total leukocytes, interleukin-8, interleukin-10, C-reactive protein, fibrinogen, superoxide dismutase and troponin did not different significantly among the patients of two groups. Interleukin-6 level in pre-and postoperative period was significantly higher in patients of group 2 (35.4±28.5 pg/ml vs 24.1±14.8 pg/ml, р=0.03; 63.7±54.8 pg/ml vs 50.7±40.8 pg/ml, р=0.04, respectively). Conclusion. Our study has shown that atorvastatin therapy contributed to the reduction of number of new cases of AF after CABG in patients with IHD. At that, the efficacy of atorvastatin therapy correlated with the size of left atrium and the severity of inflammatory response. Patients with atorvastatin therapy had significantly lower interleukin-6 level, as a proinflammatory marker, in pre-and postoperational period as compared with the patients without such treatment.

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Preoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery

Abstract: Preoperative treatment with statins is associated with a lower biochemical parameters of SIR and myocardial damage following cardiac surgery with CPB, regardless of it being coronary bypass grafting (CABG) or valvular surgery.

Cited by 46 publications

References 23 publications

Postoperative Statin Therapy Attenuates the Intensity of Systemic Inflammation and Increases Fibrinolysis After Coronary Artery Bypass Grafting

Postoperative Statin Therapy Attenuates the Intensity of Systemic Inflammation and Increases Fibrinolysis After Coronary Artery Bypass Grafting

Tumor necrosis factor-α –863 C/A promoter polymorphism affects the inflammatory response after cardiac surgery

Efficacy of atorvastatin therapy in prevention of postoperative atrial fibrillation in patients with ischemic heart disease

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