Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;32(3):191-7.
doi: 10.1016/j.joa.2016.01.010. Epub 2016 Mar 28.

Efficacy of atorvastatin in prevention of atrial fibrillation after heart valve surgery in the PROFACE trial (PROphylaxis of postoperative atrial Fibrillation After Cardiac surgEry)

Yolanda Carrascal  1 , Roman J Arnold  2 , Luis De la Fuente  2 , Ana Revilla  2 , Teresa Sevilla  2 , Nuria Arce  1 , Gregorio Laguna  1 , Pilar Pareja  1 , Miriam Blanco  1
Affiliations

Efficacy of atorvastatin in prevention of atrial fibrillation after heart valve surgery in the PROFACE trial (PROphylaxis of postoperative atrial Fibrillation After Cardiac surgEry)

Yolanda Carrascal et al. J Arrhythm. 2016 Jun.

Abstract

Background: To evaluate the efficacy of perioperative atorvastatin administration for prophylaxis of postoperative atrial fibrillation (POAF) after heart valve surgery.

Methods: Our study included 90 patients with heart valve disease who were scheduled to undergo elective cardiac surgery. Cases with previous AF or preoperative beta-blocker therapy were excluded. Patients were randomized into the atorvastatin group, which included 47 patients who received 40 mg/day of atorvastatin 7 days before and after the surgery and the control group, which included 43 patients. Primary endpoint was the occurrence of POAF. Secondary endpoints included modifications in the preoperative and postoperative levels of the markers of inflammation (C-reactive protein [CRP]), myocardial injury (ultrasensitive troponin T and creatinine phosphokinase MB [CPK-MB]), and cardiac dysfunction (pro-brain natriuretic peptide [proBNP]) related to POAF and changes in the echocardiographic parameters, such as atrial electromechanical interval, A wave, E/A ratio, and Doppler imaging systolic velocity wave amplitude, related to POAF.

Results: No relationship between atorvastatin administration and reduction in the incidence of POAF was observed (42.6% in the atorvastatin vs. 30.2% in the control group) (p=0.226). No difference in the levels of CPK-MB, ultrasensitive troponin T, CRP, or proBNP and in the analyzed echocardiographic parameter was detected between both groups.

Conclusions: Atorvastatin in the described dose, was not adequate for the prophylaxis of POAF after heart valve surgery. It was ineffective in controlling the inflammatory phenomena, myocardial injury, and echocardiographic predictors of POAF.

Keywords: Atorvastatin; Atrial fibrillation; Inflammation; Surgery; Trials.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient selection process for inclusion/exclusion in PROFACE clinical trial. CPB: cardiopulmonary bypass; AF: atrial fibrillation; LVEF: left ventricular ejection fraction.
Fig. 2
Fig. 2
Monitored levels of C-reactive protein (CRP) before and during the first 72 h after surgery.
Fig. 3
Fig. 3
(A) Monitored levels of cardiac high-sensitive cardiac troponin T (TnT) and (B) pro-brain natriuretic peptide (proBNP) before and during the first 72 h after surgery.
See this image and copyright information in PMC

References

    1. Mariscalco G., Biancari F., Zanobini M. Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score. J Am Heart Assoc. 2014;3:e000752. - PMC - PubMed
    1. Shen J., Lall S., Zheng V. The persistent problem of new-onset postoperative atrial fibrillation: a single-institution experience over two decades. J Thorac Cardiovasc Surg. 2011;141:559–570. - PMC - PubMed
    1. Mariscalco G., Engström K.G. Atrial fibrillation after cardiac surgery: risk factors and their temporal relationship in prophylactic drug strategy decision. Int J Cardiol. 2008;129:354–362. - PubMed
    1. Sareh S., Toppen W., Mukdad L. CHADS2 score predicts atrial fibrillation following cardiac surgery. J Surg Res. 2014;190:407–412. - PubMed
    1. McKeown P.P., Gutterman D. American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128(2 Suppl):1S–5S. - PubMed