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Thorac Cardiovasc Surg 2025; 73(08): 633-638
DOI: 10.1055/a-2447-0020
Original Cardiovascular

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

Authors

  • Yeiwon Lee

    1   Department of Critical Care, Seoul National University Hospital, Jongno-gu, Seoul, Korea

  • Yoonjin Kang

    2   Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Jongno-gu, Seoul, Korea

  • Ji Seong Kim

    2   Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Jongno-gu, Seoul, Korea

  • Sue Hyun Kim

    1   Department of Critical Care, Seoul National University Hospital, Jongno-gu, Seoul, Korea

  • Suk Ho Sohn

    2   Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Jongno-gu, Seoul, Korea

  • Ho Young Hwang

    1   Department of Critical Care, Seoul National University Hospital, Jongno-gu, Seoul, Korea
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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.

Keywords

coronary artery bypass grafts surgery - CABG - off-pump surgery - postoperative care - arrhythmia therapy (includes Maze; surgical ablation) - surgery - complications


Publication History

Received: 16 August 2024

Accepted: 16 October 2024

Accepted Manuscript online:
24 October 2024

Article published online:
10 December 2024

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