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 |
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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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