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.