Impact of High-intensity Statin on Atrial Fibrillation after Off-Pump Coronary Artery Bypass

Abstract

Background There is uncertainty regarding the impact of high-intensity statins on postoperative outcomes in patients undergoing surgical myocardial revascularization. This study was conducted to evaluate the impact of high-intensity statin treatment on the occurrence rate of new-onset postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCAB). Methods Six hundred and thirteen patients (66.8 +/- 9.8 years, male:female = 476:137) who underwent isolated OPCAB were retrospectively enrolled. Hypertension ( n = 409, 66.7%), diabetes mellitus ( n = 343, 59.6%), and chronic kidney disease ( n = 138, 22.5%) were common comorbidities. Statins and beta-blockers were administered to all patients until the day of surgery and resumed within 6 hours after surgery. Risk factors associated with POAF were analyzed, including the use of high-intensity statins (atorvastatin 40-80 mg or rosuvastatin 20 mg), as well as baseline characteristics and preoperative risk factors. Results High-intensity statins were used in 158 patients (25.8%). POAF occurred in 184 patients (30.0%). The use of high-intensity statins was not correlated with preoperative levels of low-density lipoprotein ( p = 0.446) or high-sensitivity C-reactive protein ( p = 0.478). Multivariate logistic regression analysis revealed that the use of high-intensity statins was significantly associated with a reduced occurrence of POAF ( p = 0.022, odds ratio [95% confidence interval] = 0.592 [0.378-0.926]). Age, acute coronary syndrome, insulin-dependent diabetes mellitus, and chronic kidney disease were also significantly associated with POAF. Conclusion Preoperative administration of high-intensity statins was associated with a 41% reduction in the occurrence rate of POAF in patients who underwent OPCAB.