[META-ANALYSIS OF CLINICAL STUDIES ON THE USE OF STATINS FOR PREVENTION OF ATRIAL FIBRILLATION SOON AFTER CORONARY BYPASS SURGERY].

BACKGROUND: Atrial fibrillation (AF) develops in the early postoperative period in each third patient undergoing coronary bypass surgery (CBPS). Multifactorial pathogenesis of postoperative AF is unclear. The concept of postoperative inflammation as a potential basic mechanism of this condition has been implied in many studies. Pre- and postoperative treatment with antiinflammatory statins proved beneficial as a means for reducing the frequency of AF.

MATERIALS AND METHODS: The meta-analysis is based on the results of 15 clinical studies carried out in the last 15 years. They included 9369 patients of whom 5598 (59.75%) used statins and 3771 (49.25%) did not receive them. The following endpoints were evaluated in the early postoperative periods: fiequency of AF, overall lethality, frequency of cerebral circulation disorders and myocardial infarction. Odds ratio (OR) and 95% CI were calculated, levels of inflammation markers before and after surgery and duration of hospitalization were determined.

RESULTS: Statins decreased the frequency of AF soon after CBPS (OR 0,481 at 95% CI 0,345-0,672; p = 0,000), they did not influence overall lethality (OR 0,837 at 95% CI 0,501-1,399: p = 0,497) and frequency of myocardial infarction (OR 1,001 at 95% CI 0,702-1,426; p = 0,997), but decreased frequency of cerebral circulation disorders (OR 0,067 at 95% Cl 0,037- 0,121; p = 0,000). Also, they reduced duration of hospitalization and serum levels of inflammation markers.

CONCLUSION: Results of clinical studies available to date leave no doubt that statins produce anti-inflammatory and anti-arrhythmic effects. Meta-analysis of relevant studies confirmed on the whole the positive role of statin therapy prior to CBPS.