• Aya G Elmarsafawi, Maggie M Abbassi, Sameh Elkaffas, Hassan M Elsawy, and Nirmeen A Sabry.
• Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Cairo University, Cairo, Egypt. Electronic address: aya.almarsafawi@pharma.cu.edu.eg.
• J. Cardiothorac. Vasc. Anesth. 2016 Dec 1; 30 (6): 1461-1470.

ObjectivesComparing different perioperative statin regimens for the prevention of post-coronary artery bypass grafting adverse events.DesignA randomized, prospective study.SettingCardiothoracic surgical units in a government hospital.ParticipantsThe study comprised 94 patients scheduled for elective, isolated on- or off- pump coronary artery bypass grafting.InterventionsPatients were assigned randomly to 1 of the following 3 treatment groups: group I (80 mg of atorvastatin/day for 2 days preoperatively), group II (40 mg of atorvastatin/day for 5-9 days preoperatively), or group III (80 mg of atorvastatin/day for 5-9 days preoperatively). The same preoperative doses were restarted postoperatively and continued for 1 month.Measurements And Main ResultsCardiac troponin I, creatine kinase, and C-reactive protein (CRP) levels were assayed preoperatively; at 8, 24, and 48 hours postoperatively; and at discharge. CRP levels at 24 hours (p = 0.045) and 48 hours (p = 0.009) were significantly lower in group III compared with the other 2 groups. However, troponin I levels at 8 hours (p = 0.011) and 48 hours (p = 0.025) after surgery were significantly lower in group II compared with group III. The incidence of postoperative major adverse cardiac and cerebrovascular events was assessed, and there was no significant difference among the 3 groups.ConclusionThe 3 regimens did not result in any significant difference in outcomes, but only simple trends. The higher-dose regimen resulted in a significant reduction in the CRP level. Thus, more studies are needed to confirm the benefit of higher-dose statins for the protection from post-coronary artery bypass grafting adverse events.Copyright © 2016 Elsevier Inc. All rights reserved.

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