Advertisement

Anti-Inflammatory Role of Statins in Preventing Postoperative Atrial Fibrillation

Published:November 09, 2015DOI:https://doi.org/10.1016/j.amjcard.2015.11.003
      The development of atrial fibrillation (AF) after cardiac surgery is a major complication, occurring in 10% to 65% of patients.
      • Patti G.
      • Chello M.
      • Candura D.
      • Pasceri V.
      • D'Ambrosio A.
      • Covino E.
      • Di Sciascio G.
      Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study.
      Despite the increasing number of studies on this issue, the pathophysiologic mechanisms leading to the postoperative AF after cardiac surgeries have not been precisely elucidated; however, some pathogenesis, including the electrophysiological remodeling of atrium, inflammation, and oxidative stress, have been hypothesized to be involved in this process.
      • Dehghani M.R.
      • Kasianzadeh M.
      • Rezaei Y.
      • Sepehrvand N.
      Atorvastatin reduces the incidence of postoperative atrial fibrillation in statin-naive patients undergoing isolated heart valve surgery: a double-blind, placebo-controlled randomized trial.
      It has been postulated that inflammation has a paramount role in the perpetuation of AF after cardiac surgery.
      • Issac T.T.
      • Dokainish H.
      • Lakkis N.M.
      Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data.
      Moreover, using cardiopulmonary bypass at cardiac surgery leads to complement activation and the subsequent elevation of CRP.
      • Bruins P.
      • te Velthuis H.
      • Yazdanbakhsh A.P.
      • Jansen P.G.
      • van Hardevelt F.W.
      • de Beaumont E.M.
      • Wildevuur C.R.
      • Eijsman L.
      • Trouwborst A.
      • Hack C.E.
      Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Patti G.
        • Chello M.
        • Candura D.
        • Pasceri V.
        • D'Ambrosio A.
        • Covino E.
        • Di Sciascio G.
        Randomized trial of atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery: results of the ARMYDA-3 (Atorvastatin for Reduction of MYocardial Dysrhythmia After cardiac surgery) study.
        Circulation. 2006; 114: 1455-1461
        • Dehghani M.R.
        • Kasianzadeh M.
        • Rezaei Y.
        • Sepehrvand N.
        Atorvastatin reduces the incidence of postoperative atrial fibrillation in statin-naive patients undergoing isolated heart valve surgery: a double-blind, placebo-controlled randomized trial.
        J Cardiovasc Pharmacol Ther. 2015; 20: 465-472
        • Issac T.T.
        • Dokainish H.
        • Lakkis N.M.
        Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data.
        J Am Coll Cardiol. 2007; 50: 2021-2028
        • Bruins P.
        • te Velthuis H.
        • Yazdanbakhsh A.P.
        • Jansen P.G.
        • van Hardevelt F.W.
        • de Beaumont E.M.
        • Wildevuur C.R.
        • Eijsman L.
        • Trouwborst A.
        • Hack C.E.
        Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia.
        Circulation. 1997; 96: 3542-3548
        • Elgendy I.Y.
        • Mahmoud A.
        • Huo T.
        • Beaver T.M.
        • Bavry A.A.
        Meta-analysis of 12 trials evaluating the effects of statins on decreasing atrial fibrillation after coronary artery bypass grafting.
        Am J Cardiol. 2015; 115: 1523-1528