阿托伐他汀对冠状动脉旁路移植术后心房颤动的影响

目的 探讨阿托伐他汀对冠状动脉旁路移植(CABG)术后心房颤动(房颤)的影响.方法 随机、对照、双盲、前瞻性研究.单纯行CABG术的患者140例,其中71例入选他汀组(术前1周服阿托伐他汀20 ms/d),69例入选对照组(不给予阿托伐他汀).使用心电监护仪对CABG患者进行术后持续心电监测至少7 d,记录房颤的发生及持续时间.术前及术后24 h、72 h、7 d检测高敏C反应蛋白(hs-CRP)水平.结果 他汀组中有10例在术后7 d内至少发生了1次房颤,显著低于对照组(14%vs 34%,P=0.009);他汀组首次房颤持续时间明显短于对照组[(3.6±0.4)h比(5.7±0.5)h,P＜0.01].Logistic回归显示使用阿托伐他汀是降低术后房颤发生的独立影响因素(OR=0.219,95%CI0.076～0.633).他汀组术后hs-CRP均显著低于对照组[术后24 h(23±5)g/L比(32±7)g/L,P＜0.01];术后72 h[(42±8)g/L vs(68±6)g/L,P＜0.01];术后7 d[(11±3)g/L比(31±9)g/L,P＜0.01].结论 阿托伐他汀能抑制CABG术后炎症反应,降低术后房颤的发生率,缩短房颤的持续时间,对CABG术后房颤有防治作用.

Effect of atorvastatin on postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting

Objective To evaluate the effect of atorvastatin on postoperative atrial fibrillation(AF) in patients undergoing coronary artery bypass gafting(CABG).Methods A cohort of 140 consecutive patients without a history of documented AF or previous statin use,who were scheduled to undergo selective CABG.were enrolled Included patients were randomly assigned to atorvastatin group(n=71) who were administered atorvastatin 20 ms/d or to control group(n=69).After CABG,subjects were monitored continuously by electrocardiographic monitors at least 7 days.During the initial postoperative 7 d,the incidence and duration of AF were recorded.And the levels of high-sensitivity C-reactive protein(hs-CRP) were meaguFed before and 24 hours,72 hours,7 days after operation,respectively.The statistical software package SPSS(version 13.0)were used to analyze the data.The differences between groups were evaluated by χ~2-test for discrete variables and student t-test for continuous variables.Multivariate logistic regression analysis was performed to determine the independent predictors of early postoperative AF.Results During initial postoperative 7 d,AF occurred at least once in 10 cages in atorvastatin group,with a prevalence ofroughly 14%,and in 23 cases in control group,with a prevalence of approximately 34%(P=0.009).The mean duration of single AF was 3.6±0.4 hours in atorvastatin group and 5.7±0.5 hours in control group (P＜0.01),respectively.The multivariate logistic analysis showed that perioperative atrovastatin administration was an independently risk factor for early postoperative AF(OR=0.219,0.076-0.633,P=0.005).There was also statistical difference in hs-CRP after CABG between the two groups.Conclusions Perioperative atrovastatin administration may inhibit inflammatory reaction,reduce the incidenee and duration of postoperative AF,hence may prevent and treat postoperative AF.