977: EFFECT OF STATIN MEDICATIONS ON THE INCIDENCE OF POSTOPERATIVE ATRIAL FIBRILLATION AFTER CARDIAC VALVE SURGERY

Abstract

Post-operative atrial fibrillation (POAF) is a frequent complication following cardiothoracic surgery and is associated with an increase in morbidity, mortality and cost. A number of studies have investigated the effect of statins on the incidence of POAF in cardiac surgery patients, but only one has focused on patients undergoing isolated cardiac valve surgery.

Preoperative statin use is associated with a decrease in POAF in patients undergoing isolated cardiac valve surgery.

All patients 18 years of age or older who underwent cardiac valve surgery between April 2007 and July 2012 at Regional Hospital of Scranton were included in this retrospective cohort study. Patients were excluded if they had a history of atrial fibrillation, underwent prior cardiac surgery, required emergent surgery, or underwent surgical ablation for atrial fibrillation. Preoperative statin use was defined according to the Society of Thoracic Surgeons Adult Cardiac Surgery Database as receiving at least one statin dose within 24 hours prior to surgery. Logistic regression was used to determine the association of preoperative statin use with POAF. A propensity score-matched analysis was also performed to adjust for potential selection bias of receiving preoperative statins.

The final analysis included 244 patients; 102 in the statin group and 142 in the control group. Patients in the statin group were older, more had a body mass index greater than 30 kg/m2, a history of diabetes mellitus, hypertension, cerebrovascular disease, peripheral artery disease, and myocardial infarction, and more were on preoperative beta blockers. The incidence of POAF was 37.3% in the statin group and 27.5% in the control group. Univariate analysis demonstrated no association of statins with POAF (OR 1.38; 95% CI 0.796-2.39). Multivariable analysis also showed no association of POAF with preoperative statin use (OR 0.919 95% CI 0.479-1.76). Repeating the analysis in 60 propensity score-matched patients also failed to demonstrate any association (OR 0.75; 95% CI 0.262-2.15).

Preoperative statin use is not associated with a decrease in POAF in patients undergoing isolated cardiac valve surgery.