High-dose atorvastatin improves preconditioning in CABG surgery: Study
Iran: Pretreatment with high-dose atorvastatinin patients who already received an atorvastatin medication regimen helped in improving preconditioning following CABG surgery, according to a recent study in the Annals of Cardiac Anaesthesia.
Coronary artery bypass grafting (CABG), a surgery that improves blood flow to the heart, is associated with major mortality and morbidity from peri-procedural myocardial injury that leads to short- and long-term clinical complications.
Ischemic preconditioning implies transient periods of ischemia that increases myocardium resistant to consequent ischemic injury and reperfusion events. Intracellular mechanisms' discernment of ischemic preconditioning reveals new possibilities for introduction of pharmacological preconditioning in human models.
Atorvastatin is considered as lipid reductive drugs with anti-inflammatory and pleotherapic effects in CABG. Misagh Bastani, Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, and colleagues aimed to evaluate the effects of atorvastatin in CABG.
The study included patients who had undergone CABG in Nemazee hospital in Shiraz, Iran. They were divided into two 50-groups receiving high-dose (80 mg) and low-dose (20 mg) atorvastatin.
Troponin I, creatinine kinase-MB (CK-MB), atrial fibrillation (AF) after CABG, duration of mechanical ventilation, inotrope duration of consumption, blood sugar profile, liver and renal function, death were analyzed during 30 days of CABG, MACE (major advance cardiac events) during admission in ICU, and 1 month follow up.
Key findings of the study include:
- AST was increased, ALT, ALK-P after CABG were decreased, and urine volume in the second day of admission in ICU was increased in the high-dose group.
- There was an increase and following decrease in blood sugar of patients in the high-dose after CABG. An inflammatory marker after CABG was raised in both groups, ck-mb had an increase, and then followed by a reduction.
- Troporin had no significant differences between groups.
- Patients with high-dose atorvastatin had better glomerular filtration rate and renal performance.
- Along with decreasing AF in the case group, hemodynamics' disorder reduced and there was less bleeding.
"According to the above, it seems that a short-time prescription of high dose of atorvastatin in CABG can lead to better renal function, decreasing of arrhythmia and AF," concluded the authors.
The study titled, "Evaluation of high-dose atorvastatin pretreatment influence in patients preconditioning of post coronary artery bypass graft surgery: A prospective triple blind randomized clinical trial," is published in the Annals of Cardiac Anaesthesia.