Abstract
BackgroundStatin pretreatment has been associated with a decrease in myocardial ischemia markers after various procedures and cardiovascular events. This study examined the potential beneficial effects of preoperative atorvastatin treatment among patients undergoing on-pump CABG operation.MethodsTwenty patients that had received atorvastatin treatment for at least 15 days prior to the operation and 20 patients who had not received any antihyperlipidemic agent prior to surgery were included in this study. CK-MB and troponin I levels were measured at baseline and 24 hours after the operation. Perioperative variables were also recorded.ResultsTwenty-four hours after the operation, troponin I and CK-MB levels were significantly lower in the atorvastatin group: for CK-MB levels, 12.9 ± 4.3 versus 18.7 ± 7.4 ng/ml, p = 0.004; for troponin I levels, 1.7 ± 0.3 versus 2.7 ± 0.7 ng/ml, p < 0.001. In addition, atorvastatin use was associated with a decrease in the duration of ICU stay.ConclusionsPreoperative atorvastatin treatment results in significant reductions in the levels of myocardial injury markers early after on-pump CABG operation, suggesting a reduction in perioperative ischemia in this group of patients. Further studies are needed to elucidate the mechanisms of these potential benefits of statin pretreatment.
Highlights
Statin pretreatment has been associated with a decrease in myocardial ischemia markers after various procedures and cardiovascular events
This study examined the potential beneficial effects of preoperative atorvastatin treatment given for at least 15 days before on-pump coronary artery bypass grafting (CABG) on myocardial injury indicators, CK-MB and troponin I
Troponin I and CK-MB levels were similar at baseline (Table 1), 24 hours after the operation both levels were significantly lower in the group that had received atorvastatin compared to controls: for CK-MB levels, 12.9 ± 4.3 versus 18.7 ± 7.4 ng/ml, p = 0.004; for troponin I levels, 1.7 ± 0.3 versus 2.7 ± 0.7 ng/ml, p < 0.001 (Figure 1)
Summary
Statin pretreatment has been associated with a decrease in myocardial ischemia markers after various procedures and cardiovascular events. Ambulatory use of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, or statins, is known to reduce the risk of cardiovascular events including death, myocardial infarction, stroke, and renal function, in addition to their lowering effect on low-density lipoprotein (LDL) and total cholesterol levels [1]. Patients with normal or low levels of LDL benefit from long term statin treatment with lower incidence of cardiovascular events and reduced need for coronary angioplasty or coronary surgery [2]. Cardiac isoforms of troponin are specific markers for myocardial injury. They are highly sensitive indicators for perioperative myocardial ischemia [3].
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