Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein Journal Article

Authors: Amar, D.; Zhang, H.; Heerdt, P. M.; Park, B.; Fleisher, M.; Thaler, H. T.
Article Title: Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein
Abstract: Study objectives: The level of C-reactive protein (CRP) has been shown to be elevated in patients with atrial fibrillation/flutter (AF) unrelated to surgery, and statins are known to lower the CRP level. To determine whether an elevated CRP level predisposes the patient to postoperative AF and whether statin use is associated with a reduced AF incidence, we studied a consecutive group of patients who were at risk for AF after undergoing thoracic surgery (age, ≥ 60 years). Design and setting: A prospective study in a tertiary care cancer center of 131 patients (mean [± SD] age, 73 ± 6 years) who had undergone major lung or esophageal resection. High-sensitivity CRP and interleukin (IL)-6 levels were measured before surgery, on arrival at the postanesthesia care unit, and on the first morning after surgery. Continuous telemetry was used for 72 to 96 h to detect AF. Results: AF occurred in 38 of 131 patients (29%) at a median time after surgery of 3 days. Although CRP and IL-6 levels increased significantly (p < 0.001) in response to surgery, patients with or without AF did not differ in perioperative values. In a stepwise logistic regression, statin use was associated with a threefold decrease in the odds of developing AF (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.82; p = 0.022) and a greater PR interval (OR, 1.11 per 5-ms increments; 95% CI, 1.01 to 1.22; p = 0.027) predicted an increase in the risk of AF. Conclusions: The preoperative use of statins was associated with a protective effect against postoperative AF independent of CRP levels. In contrast to AF in the general population, early markers of inflammation did not predict the postoperative occurrence of AF.
Keywords: adult; controlled study; aged; aged, 80 and over; major clinical study; disease marker; postoperative care; preoperative evaluation; prospective study; sensitivity and specificity; prospective studies; c reactive protein; pneumonectomy; inflammation; risk factors; c-reactive protein; drug effect; high risk patient; risk assessment; postoperative complications; nonsteroid antiinflammatory agent; interleukin 6; interleukin-6; esophagus resection; complications; preoperative treatment; risk reduction; thorax surgery; heart atrium fibrillation; telemetry; atrial fibrillation; atorvastatin; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; simvastatin; protein determination; heart protection; esophagectomy; roc curve; arrhythmias; hydroxymethylglutaryl-coa reductase inhibitors; pravastatin; statine derivative; heart atrium flutter
Journal Title: Chest
Volume: 128
Issue: 5
ISSN: 0012-3692
Publisher: American College of Chest Physicians  
Date Published: 2005-11-01
Start Page: 3421
End Page: 3427
Language: English
DOI: 10.1378/chest.128.5.3421
PUBMED: 16304294
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 106" - "Export Date: 24 October 2012" - "CODEN: CHETB" - "Source: Scopus"
Citation Impact
MSK Authors
  1. David Amar
    125 Amar
  2. Bernard J Park
    194 Park
  3. Martin Fleisher
    295 Fleisher
  4. Howard T Thaler
    239 Thaler
  5. Paul Heerdt
    46 Heerdt
  6. Hao Zhang
    54 Zhang