Abstract
Background: The purpose of the present study was to assess the preventive effect of preoperative statin treatment on atrial fibrillation (AF) after elective isolated off-pump coronary artery bypass grafting (off-pump CABG) in propensity score-matched Japanese patients. Methods and Results: Among 770 consecutive patients undergoing isolated CABG by the same surgeon (99.2% with off-pump technique without conversion to cardiopulmonary bypass) between 2002 and 2009, after excluding emergency (n=150), chronic AF (n=30), and use of cardiopulmonary bypass (n=6), 584 patients were retrospectively reviewed. Of this cohort, 364 patients received statin at least 5 days before operation and 220 patients received no statin. We identified 195 propensity score-matched pairs. Propensity scores were created based on 8 preoperative factors (C statistics, 0.69). There was no significant difference between the 2 groups in baseline characteristics, perioperative medications, or operative procedures. AF occurred in 14.4% in the statin group and in 24.6% in the no statin group (P=0.01). Multivariate logistic regression including potential univariate predictors identified statin (odds ratio [OR] =0.49; 95% confidence interval [95%CI] =0.22-0.81; P=0.01), age (OR =1.33 per 10-year increase; 95%CI =1.04-1.69; P=0.02), and transfusion (OR =2.21; 95%CI =1.38-3.55; P=0.01) as independent predictors of postoperative AF. Conclusions: Preoperative statin significantly reduces the incidence of AF after elective isolated off-pump CABG in Japanese patients. (Circ J 2010; 74: 1846 - 1851)
