Perioperative statin administration with decreased risk of postoperative atrial fibrillation, but not acute kidney injury or myocardial infarction: A metaanalysis

A controversy effect of perioperative statin use for preventing postoperative atrial fibrillation (POAF) and acute kidney injury (AKI) after cardiac surgery still remains. We thus performed current systematic review and meta-analysis to comprehensively evaluate effects of statin in cardiac surgery. 22 RCTs involving 5243 patients were included. Meta-analysis of 18 randomized controlled trials with 3995 participants suggested that perioperative statin use could decrease the risk of POAF (relative risk [RR] 0.69, 95% CI 0.56 to 0.86, P = 0.001), with a moderate heterogeneity (I-2 = 65.7%, P-H < 0.001). And the beneficial effect was found only in patients receiving coronary artery bypass graft (CABG), but not in patients undergoing valve surgery. However, perioperative statin use was not associated with lower risks of AKI (RR 0.98, 95% CI 0.70 to 1.35, P = 0.884, I-2 = 33.9%, P-H = 0.157) or myocardial infarction (MI) (RR 0.84, 95% CI 0.58 to 1.23, P = 0.380, I-2 = 0%, P-H = 0.765), and even an increased trend of AKI was observed in patients with valve surgery. Perioperative statin use could decrease the inflammation response with no impact on clinical outcomes. In conclusion, perioperative statin use is useful in preventing POAF, particularly in patients with CABG, and ameliorate inflammation, while it has no effect on AKI and MI after cardiac surgery.