INTRODUCTION
Postoperative complications frequently occur after cardiac surgery,
leading to significant increases in mortality, morbidity, and costs1 . Notably, approximately 15 to 40 percent of
patients who underwent coronary artery bypass graft surgery (CABG)2-5 , as well as 38 to 50 percent after valve
surgery 2,6,7 , experience postoperative
atrial fibrillation (POAF) in the early postoperative period. Several
studies showed that POAF is associated with increased in-hospital and
long-term mortality rates 3-5, 8-10 and
prolonged hospitalization 6,10-12 .
Pathophysiologically, POAF is believed to be related to inflammatory
processes, leading to oxidative stress 13 . In
particular, a strict connection exists between the peak of the systemic
inflammatory response after cardiac surgery and the POAF occurrence13 .
Interestingly, among the pleiotropic effects of statins are their
anti-inflammatory and antioxidant properties14-16 . Thus, some clinical and experimental
studies have suggested using statins to protect against atrial
fibrillation 17 . In keeping with these
findings, some meta-analyses made from randomized clinical trials showed
that preoperative statin therapy, generally introduced in the week
before cardiac surgery, had been associated with a lower incidence of
POAF 18,19 . However, these studies pointed
out significant limitations of the evidence.
Indeed, considering the high burden of bias and the new valuable trials
conducted, we performed our study to update the current knowledge
regarding statins’ potential role in preventing POAF.