1. Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials
- Author
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Ahmet Rüçhan Akar, Giuseppe Patti, Öcal Berkan, Annunziata Nusca, Ilaria Cavallari, Vincenzo Pasceri, Young Keun On, Carlos Caorsi, Simona Mega, Massimo Chello, Germano Di Sciascio, Sreenivasa Rao Kondapally Seshasai, Kausik K. Ray, Nurkay Katrancioglu, Cristiano Spadaccio, Qiang Ji, Christopher P. Cannon, Mehmet Yilmaz, Rachel Bennett, Vito Mannacio, Antonios Kourliouros, Çağdaş Baran, Juan Carlos Kaski, Giuseppe, Patti, Rachel, Bennett, Sreenivasa Rao Kondapally, Seshasai, Christopher P., Cannon, Ilaria, Cavallari, Massimo, Chello, Annunziata, Nusca, Simona, Mega, Carlos, Caorsi, Cristiano, Spadaccio, Young Keun, On, Mannacio, VITO ANTONIO, Ocal, Berkan, Mehmet B., Yilmaz, Nurkaykatrancioglu, Qiang, Ji, Antonios, Kourliouro, Çag˘das¸, Baran, Vincenzo, Pasceri, Ahmet Ru¨c¸han, Akar, Juan Carlos, Kaski, Germano Di, Sciascio, Kausik, K. R. a. y., [Patti, Giuseppe -- Cavallari, Ilaria -- Chello, Massimo -- Nusca, Annunziata -- Mega, Simona -- Di Sciascio, Germano] Campus Biomed Univ Rome, Dept Cardiovasc Sci, Rome, Italy -- [Bennett, Rachel -- Seshasai, Sreenivasa Rao Kondapally -- Kaski, Juan Carlos] St Georges Univ London, Cardiovasc Sci Res Ctr, London SW17 0RE, England -- [Cannon, Christopher P.] Harvard Univ, Brigham & Womens Hosp, Sch Med, Cardiovasc Div, Boston, MA 02115 USA -- [Caorsi, Carlos] Hosp Clin Fuerza Aerea Chile, Clin Las Condes, Cardiovasc Dept, Las Condes, Chile -- [Spadaccio, Cristiano] Univ Hosp UZ Leuven, Cardiovasc Dis Dept, Leuven, Belgium -- [Spadaccio, Cristiano] Univ Hosp UZ Leuven, Dept Cardiac Surg, Leuven, Belgium -- [Spadaccio, Cristiano] Ziekenhuis Oost Limburg, Dept Cardiac Surg, Genk, Belgium -- [On, Young Keun] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Med, Seoul, South Korea -- [Mannacio, Vito] Univ Naples Federico II, Dept Cardiac Surg, Naples, Italy -- [Berkan, Ocal] Cumhuriyet Univ, Sch Med, Dept Cardiac Surg, Sivas, Turkey -- [Yilmaz, Mehmet B. -- Katrancioglu, Nurkay] Cumhuriyet Univ, Sch Med, Dept Cardiol, Sivas, Turkey -- [Ji, Qiang] Tongji Univ, Tongji Hosp, Dept Thorac & Cardiovasc Surg, Shanghai 200092, Peoples R China -- [Kourliouros, Antonios] Kings Coll Hosp London, Dept Cardiothorac Surg, London, England -- [Baran, Cagdas -- Akar, Ahmet Ruechan] Ankara Univ, Sch Med, Ctr Heart, Dept Cardiovasc Surg, Dikimevi, Turkey -- [Pasceri, Vincenzo] San Filippo Neri Hosp Rome, Intervent Cardiol, Rome, Italy, Akar, Ahmet Ruchan -- 0000-0002-5191-5505, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Patti, Giuseppe -- 0000-0002-5404-3968, and di sciascio, germano -- 0000-0003-0862-3619
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medicine.medical_specialty ,Statin ,medicine.drug_class ,Placebo ,law.invention ,Postoperative Complications ,Randomized controlled trial ,law ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,Odds Ratio ,medicine ,Humans ,Cardiac Surgical Procedures ,Randomized Controlled Trials as Topic ,business.industry ,Statins ,Atrial fibrillation ,Odds ratio ,Cardiac surgery ,medicine.disease ,Postoperative atrial fibrillation ,Surgery ,Meta-analysis ,Treatment Outcome ,Observational study ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business - Abstract
WOS: 000356221100004, PubMed ID: 25733550, Aims Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF). However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine anti-arrhythmic benefits of these agents in this setting. We therefore aimed to quantify precisely the association between statin pretreatment and postoperative AF among patients undergoing cardiac surgery. Methods and results A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012) was conducted, followed by a review of the reference lists of published studies and correspondence with trial investigators to obtain individual-participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting >= 5 min. Overall, 1105 participants from 11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval 0.31-0.54, P< 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatment was consistent across different subgroups. Conclusion Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery., Kowa; Accumetrics; Astra Zeneca; Takeda; Essentials; GSK; Regeneron; Sanofi; Merck, K.K.R. reports to receiving honoraria for advisory boards, consultancy, steering committees, and lectures from Pfizer, Astra Zeneca, Abbott, Roche, MSD, Sanofi, Amgen, Regeneron, Aegerion, Kowa, Novartis, Novo Nordisk, Boehringer Ingelheim, Daiichi Sankyo, and Lilly. S.R.K.S. reports to receiving honoraria from Amgen for consultancy, and an unrestricted educational grant (to research group) from Kowa. C.P.C. reports to receiving honoraria for advisory boards, consultancy, travel, and/or meeting expenses from Merck, BMS, Alnylam, Pfizer, CSL, Astra Zeneca, GSK, Regeneron, Sanofi, and Takeda; grants from Accumetrics, Astra Zeneca, Takeda, Essentials, GSK, Regeneron, Sanofi, and Merck; and reports to holding stocks in Audiometrics.
- Published
- 2015
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