- Meta-analysis
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Impact of perioperative high-intensity statin treatment on the occurrence of postoperative atrial fibrillation after coronary artery bypass grafting: a meta-analysis
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Yeiwon Lee, Somin Im, Yoonjin Kang, Suk Ho Sohn, Myoung-jin Jang, Ho Young Hwang
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Acute Crit Care. 2024;39(4):507-516. Published online November 25, 2024
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DOI: https://doi.org/10.4266/acc.2024.00633
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Abstract
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- Background
This meta-analysis was conducted to evaluate the impact of high-intensity statin
treatment on new-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting
(CABG).
Methods Four databases were searched for studies that enrolled patients who underwent CABG
and investigated the impact of perioperative use of high-intensity statins on the occurrence rate
of POAF. The primary outcome was the incidence of POAF. Secondary outcomes were operative
mortality and perioperative myocardial infarction (PMI). Publication bias was assessed using a funnel
plot and Egger’s test.
Results Nine articles (eight randomized controlled trials and one non-randomized study: n=3,072)
were selected. Rosuvastatin (20 mg) was used in four studies, while atorvastatin (40–80 mg) was
used in the other five studies. Reported incidences of POAF in the included studies ranged from
11% to 48.8%. Pooled analyses showed that the incidence of POAF was significantly lower in patients
treated with high-intensity statins than in patients in the control group patients (odds ratio,
0.43; 95% CI, 0.27–0.68; P<0.001). Subgroup analyses showed that the impact of high-intensity
statins was significant in studies using atorvastatin but not in studies using rosuvastatin. There
was no significant subgroup difference in the primary endpoint between studies using a placebo
and those using low-dose statins. Secondary outcomes, including operative mortality and the incidence
of PMI, were not affected by high-intensity statin treatment.
Conclusions Perioperative use of high-intensity statins is associated with a 57% reduction in the
occurrence of POAF among patients undergoing CABG.
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