• Essam Abd Allah, Emad Zarief Kamel, Hany M Osman, Sayed Kaoud Abd-Elshafy, Fatma Nabil, Tarek Taha Hanafy Elmelegy, Hussein Elkhayat, Abdelrady Shehata Ibrahim, and Ahmed Al Minshawy.
• Anesthesia and ICU department, Faculty of Medicine, Assiut University, Assiut, Egypt.
• J. Cardiothorac. Vasc. Anesth. 2019 Dec 1; 33 (12): 3340-3347.

ObjectivesTo evaluate the role of prophylactic high-dose atorvastatin for prevention of postoperative atrial fibrillation (POAF), inflammatory response attenuation, and myocardial protection after valve replacement cardiac surgery.DesignRandomized controlled trial.SettingAssiut University Hospitals.ParticipantsSixty-four adult patients undergoing cardiac valve replacement surgery.InterventionsThe participants were equally divided into 2 groups. Group S received 80 mg of atorvastatin (oral tablets), 12 and 2 hours preoperatively, and on the 2nd, 3rd, 4th, and 5th postoperative days. Control group C received placebo at the same time periods.MeasurementsThe incidence of POAF, postoperative white blood cell count, serum C-reactive protein, interleukin 6, and troponin I.Main ResultsGroup S patients showed a lower incidence of POAF compared with the placebo group (p = 0.031). The white blood cell count showed significant reductions in group S compared with group C on the second, third, fourth, and fifth postoperative days. The C-reactive protein level showed significant reductions on the third, fourth, and fifth postoperative days in group S compared with group C (p = 0.001, 0.001, and 0.001, respectively). The serum level of interleukin 6 showed a significant reduction on the fifth postoperative day in group S compared with group C (p = 0.001). There was no significant difference between the 2 groups regarding the troponin I level and inotropic score.ConclusionProphylactic use of high dose atorvastatin can decrease the incidence of POAF and attenuate the inflammatory process in adult patients undergoing isolated rheumatic cardiac valve replacement surgery.Copyright © 2019 Elsevier Inc. All rights reserved.

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