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

Abstract

To evaluate the effect of preoperative statin use on the incidence of postoperative atrial fibrillation (POAF) in patients undergoing isolated cardiac valve surgery. Single-center retrospective cohort study. Mixed medical-surgical intensive care unit in a community hospital. A total of 244 adults who underwent isolated cardiac valve surgery between April 2007 and July 2012; of these patients, 102 received preoperative statins (defined as receiving at least one dose of a statin within 24 hours prior to surgery), and 142 did not receive preoperative statins (control group). The primary outcome was the occurrence of POAF. Logistic regression was used to determine the association between preoperative statin use and occurrence of POAF. A propensity score-matched (PSM) analysis was also performed. Patients in the statin group were older, had a higher body mass index, frequency of diabetes mellitus, hypertension, cerebrovascular disease, peripheral artery disease, myocardial infarction, and preoperative β-blocker use. POAF occurred in 35 patients (34.3%) in the statin group and 39 patients (27.5%) in the control group. Univariate analysis demonstrated no association between statin use and the occurrence of POAF (odds ratio [OR] 1.38, 95% confidence interval [CI] 0.796-2.39). Multivariable analysis also showed no association between POAF and preoperative statin use (OR 1.09, 95% CI 0.566-2.09). Repeating the analysis in 128 PSM patients demonstrated no association (OR 1.08, 95% CI 0.507-2.29). 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.