ABSTRACT
Background: Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass grafting (CABG), occurring in 20% to 40% of patients. Statins exert pleiotropic effects which are largely independent from their lipid-lowering properties. The objective of this study was based on to affirm the evidence that perioperative statins have a significant role in preventing early postoperative AF in patients undergoing CABG.Methods: A prospective, randomized, cohort study of all consecutive patients who underwent primary isolated on pump CABG surgery was performed. Patients were divided into two groups -statin and non-statin groups - to examine the influence of statins on early postoperative prevention of AF.Results: In total, 127 patients who underwent isolated CABG were included in the study and were analysed. There were no significant differences in age, gender, history of cardiac infarction, concomitant diseases (hypertension, smoking, PPCI, hyperlipidaemia), cardiac functional grading (NYHA III-IV), electro- cardiograms, and preoperative medication. There were no significant differences in the average number of grafts where the left internal mammary artery was used as a bypass conduit, the surgical procedure or total cardiopulmonary bypass time, or aortic cross-clamping (ACC) time. In addition, there were no significant differences in the postoperative mechanical ventilation duration time, length of ICU stays or length of hospitalization between the two groups. The incidence of AF following CABG in the statin group was significantly lower than that in the non-statin group.Conclusions: Oral atorvastatin 40 mg/d, initiated at least 1 week before the scheduled CABG and continued in the early postoperative period, significantly decreases the risk of post-operative AF.
ABSTRACT
Background: Acute kidney injury (AKI) is one of the most serious complications during the postoperative period of cardiac surgery. Multiple variables predict the ARF after cardiac surgery. Objective of this study was to evaluate the significance of pre and peri-operative variables which may help in predicting the chances of developing ARF after cardiac surgery.Methods: This study was an observational, prospective study conducted among patients who were scheduled to undergo open heart surgery under cardiopulmonary bypass.Results: In total, 50 patients who underwent open-heart surgery, ARF was seen in 5 patients, with the incidence rate of 10%. Acute renal failure was present in one patient with ejection fraction <35, 2 patients had ejection fraction between 35 to 50 and 2 patients with ejection fraction >50. It was seen in 4 patients with 1-2 hrs of cardiopulmonary bypass and in 1 patient with >2 hrs of cardiopulmonary bypass. ARF was also seen in 4 patients with hematocrit between 22-26% and in 1 patient with >26%.Conclusions: The study provided a clinical variable score that can predict ARF after open-heart surgery. The score enhances the accuracy of prediction by accounting for the effect of all major risk factors of ARF.