• Critical care medicine · Mar 2006

    Randomized Controlled Trial

    Effects of atorvastatin on systemic inflammatory response after coronary bypass surgery.

    • Massimo Chello, Giuseppe Patti, Dario Candura, Stefano Mastrobuoni, Germano Di Sciascio, Felice Agrò, Massimiliano Carassiti, and Elvio Covino.
    • Interdisciplinary Center for Biomedical Research, University Campus BioMedico di Roma, Italy. m.chello@unicampus.it
    • Crit. Care Med. 2006 Mar 1; 34 (3): 660-7.

    ObjectivesSystemic inflammatory response occurs frequently after coronary artery bypass surgery, and it is strongly correlated with the risk of postoperative morbidity and mortality. Recent studies demonstrate that treatment with statin is associated with a significant and marked decrease in inflammation-associated variables such as the C-reactive protein, cytokines, and adhesion molecules. Therefore, we investigated the effects of preoperative atorvastatin treatment on systemic inflammatory response and perioperative morbidity after cardiopulmonary bypass.DesignDouble-blinded, placebo-controlled, randomized study.SettingUniversity hospital.PatientsForty patients were randomized to treatment with atorvastatin (20 mg/day, group A, n=20) or placebo (group B, n=20) 3 wks before surgery.InterventionsThree-week treatment by atorvastatin 20 mg/day.Measurement And Main ResultsPostoperative serum levels of both interleukin-6 and interleukin-8 increased significantly over baseline, but the peak levels observed 4 hrs postoperatively were significantly lower in the atorvastatin group. In the same fashion, CD11b expression on neutrophils was significantly lower in the statin group at 4 and 24 hrs postoperatively. Finally, neutrophil-endothelial adhesion was significantly reduced in the statin patients compared with controls. The operation time, blood loss, need for inotropic support, intubation time, and length of intensive care unit or hospital stay did not differ significantly between the two groups. The systemic inflammatory response syndrome score on postoperative days 1 and 2 was comparable in both groups.ConclusionsPretreatment with atorvastatin significantly reduces cytokine release and neutrophil adhesion to the venous endothelium in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.

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