Postoperative atrial fibrillation in patients on statins undergoing isolated cardiac valve surgery: a meta-analysis
Introduction: The efficacy of perioperative statin therapy in decreasing postoperative morbidity in patients undergoing valve replacements and repairs is unknown. The aim of our study was to determine whether or not the literature supports the hypothesis that statins decrease postoperative atrial fibrillation (AF), and hence improve short-term postoperative outcomes in patients undergoing isolated cardiac valve surgery.
Method: We conducted a meta-analysis of studies on postoperative outcomes associated with statin therapy following isolated valve replacement or repair. The data was taken from published studies on valvular heart surgery patients. Participants were patients who underwent either isolated cardiac valve replacement or repair. Patients in the intervention group received statins prior to their surgery. Three databases were searched: Ovid Healthstar, 1966 to April 2012; Ovid Medline, 1946 to 31 May 2012; and Embase, 1974 to 30 May 2012. The meta-analysis was conducted using Review Manager® version 5.1.
Results: Statins did not decrease the incidence of postoperative AF in patients undergoing isolated cardiac valve surgery [odds ratio (OR) 1.19, 95% confidence interval (CI): 0.80– 1.77)], although there was significant heterogeneity for the outcome of postoperative AF (I2 55%, 95% CI: 27–72). Statins were associated with a decrease in 30-day mortality (OR 0.43, 95% CI: 0.24–0.75).
Conclusion: Although this meta-analysis suggests that chronic statin therapy did not prevent postoperative AF in unselected valvular heart surgical patients, the heterogeneity indicates that this outcome should be viewed with caution and further research is recommended.
Keywords: atrial fibrillation, cardiac surgery, statins