Could Short-Term Perioperative High-Dose Atorvastatin Offer Antiarrhythmic and Cardio-Protective Effects in Rheumatic Valve Replacement Surgery?

Autor: Ahmed Al Minshawy, Emad Zarief Kamel, Sayed Kaoud Abd-Elshafy, Essam Abd Allah, Fatma Nabil, Hussein Elkhayat, Tarek T El-Melegy, Abdelrady S Ibrahim, Hany M. Osman
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Atorvastatin
medicine.medical_treatment
030204 cardiovascular system & hematology
Placebo
Perioperative Care
law.invention
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
Valve replacement
030202 anesthesiology
law
Atrial Fibrillation
Troponin I
medicine
Humans
Prospective Studies
Heart Valve Prosthesis Implantation
Dose-Response Relationship
Drug
business.industry
Incidence
Rheumatic Heart Disease
Atrial fibrillation
Perioperative
Middle Aged
medicine.disease
Heart Valves
Cardiac surgery
Treatment Outcome
Anesthesiology and Pain Medicine
Anesthesia
Egypt
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
medicine.drug
Zdroj: Journal of Cardiothoracic and Vascular Anesthesia. 33:3340-3347
ISSN: 1053-0770
Popis: Objectives To evaluate the role of prophylactic high-dose atorvastatin for prevention of postoperative atrial fibrillation (POAF), inflammatory response attenuation, and myocardial protection after valve replacement cardiac surgery. Design Randomized controlled trial. Setting Assiut University Hospitals. Participants Sixty-four adult patients undergoing cardiac valve replacement surgery. Interventions The participants were equally divided into 2 groups. Group S received 80 mg of atorvastatin (oral tablets), 12 and 2 hours preoperatively, and on the 2nd, 3rd, 4th, and 5th postoperative days. Control group C received placebo at the same time periods. Measurements The incidence of POAF, postoperative white blood cell count, serum C-reactive protein, interleukin 6, and troponin I. Main Results Group S patients showed a lower incidence of POAF compared with the placebo group (p = 0.031). The white blood cell count showed significant reductions in group S compared with group C on the second, third, fourth, and fifth postoperative days. The C-reactive protein level showed significant reductions on the third, fourth, and fifth postoperative days in group S compared with group C (p = 0.001, 0.001, and 0.001, respectively). The serum level of interleukin 6 showed a significant reduction on the fifth postoperative day in group S compared with group C (p = 0.001). There was no significant difference between the 2 groups regarding the troponin I level and inotropic score. Conclusion Prophylactic use of high dose atorvastatin can decrease the incidence of POAF and attenuate the inflammatory process in adult patients undergoing isolated rheumatic cardiac valve replacement surgery.
Databáze: OpenAIRE
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