Statin for Prevention of Atrial Fibrillation After Off-Pump Coronary Artery Bypass Grafting in Japanese Patients

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= 133 per 10-year increase, 95 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)