Statins vs. arrhythmias after bypass
Atrial fibrillation (AF) is a common arrhythmia following open heart surgery. Patients who develop postoperative atrial fibrillation are more likely to have other complications during or after surgery, including, heart attack, congestive heart failure and respiratory failure. Postoperative atrial fibrillation is associated with longer Intensive Care Unit and hospital stays.
Age has been identified as the major independent predictor of post-operative AF. Increasing age of patients accounts for the higher incidence of postoperative AF in recent years. Incidence of AF after CABG far exceeds the reported prevalence in the general population and in patients with coronary artery disease(CAD). Similarly, it is significantly higher than the reported incidence of AF after major noncardiac surgery regardless of CAD status.
The mechanisms responsible for the high incidence of AF after CABG surgery is unclear. Some of the mechanisms suggested are:
- ß-blocker withdrawal,
- the use of cardiopulmonary bypass,
- inadequate atrial protection,
- and overmanipulation of the right atrium.
According to a new report, treatment with a cholesterol-lowering statin drug appears to reduce the risk of atrial fibrillation following coronary artery bypass grafting (CABG) by about 50%.
Overall, 28% of subjects developed atrial fibrillation. A history of atrial fibrillation raised the risk of postoperative atrial fibrillation by nearly 12-fold, whereas statin use cut the risk by 48%.
The study findings "may have important clinical implications because atrial fibrillation is a frequent complication after cardiac surgery that increases in-hospital morbidity and mortality and prolongs hospital stay," the authors conclude.