Original Researchs
DOI: http://doi.org/10.31928/2305-3127-2018.1.1424
The efficacy and safety of peroperative statin treatment during coronary artery bypass grafting
I.V. Shklianka 1, 2, O.J. Zharinov 1, К.O. Mikhaliev 3 ,O.A. Yepanchintseva 1, 2, B.M. Todurov 1, 2
1 Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
2 Heart Institute of Healthcare Ministry of Ukraine, Kyiv, Ukraine
3 State Scientific Institution «Scientific and Practical Center of Preventive and Clinical Medicine» State Government Affairs, Kyiv, Ukraine
The aim – to evaluate the efficacy and safety of perioperative statins treatment during coronary artery bypass graft surgery (CABG).
Materials and methods. The data from clinical and instrumental examination of 155 patients with stable coronary heart disease (CHD) consecutively selected for CABG surgery were analyzed in a single-center study. Depending on perioperative statins usage, patients were retrospectively divided into three groups: group one – did not receive statins at least one week before surgery (n = 30), group two – received statins in moderate or low doses (n = 107), group three – received statins in high doses for at least one week before surgery (n = 18). Patients receiving high-intensity statin therapy for less than 7 days prior to surgery were included in group two.
Results The clinical groups had no significant differences in concomitant diseases and demographic parameters. Postoperative complications occurred in total in 66 (42.6 %) patients. The lack of perioperative statin therapy was associated with a more frequent occurrence of postoperative complications compared with statins in moderate and high doses (73 %, 36 %, 28 % of patients in clinical groups, respectively, р1-2 = 0.003, р1-3 = 0.018). The incidence of postoperative atrial fibrillation was significantly lower in groups two and three, compared to group one (р1–2 < 0.001 and р1–3 < 0.001). In group one there were 4 cases of acute heart failure, one case of acute myocardial infarction, one acute respiratory failure and one significant blockade, which required the implantation of a pacemaker, while in other groups such cases were not recorded. Cases of acute kidney damage were noted with the same frequency in groups two and three (by 10 %), in group three – were not registered. There were no significant differences in groups regarding serum transaminases.
Conclusions The lack of perioperative statin therapy is associated with higher incidence of postoperative complications. Perioperative statin initiation was associated with decrease in the frequency of postoperative atrial fibrillation and not accompanied by significant changes of liver and kidney markers dysfunction, including group of patients receiving high doses of statins.
Key words: coronary artery bypass graft surgery, statins, perioperative period, complications.
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