Statin for prevention of atrial fibrillation after off-pump coronary artery bypass grafting in Japanese patients.

BACKGROUND The purpose of the present study was to assess the preventive effect of preoperative statin treatment on atrial fibrillation (AF) after elective isolated off-pump coronary artery bypass grafting (off-pump CABG) in propensity score-matched Japanese patients. METHODS AND RESULTS Among 770 consecutive patients undergoing isolated CABG by the same surgeon (99.2% with off-pump technique without conversion to cardiopulmonary bypass) between 2002 and 2009, after excluding emergency (n=150), chronic AF (n=30), and use of cardiopulmonary bypass (n=6), 584 patients were retrospectively reviewed. Of this cohort, 364 patients received statin at least 5 days before operation and 220 patients received no statin. We identified 195 propensity score-matched pairs. Propensity scores were created based on 8 preoperative factors (C statistics, 0.69). There was no significant difference between the 2 groups in baseline characteristics, perioperative medications, or operative procedures. AF occurred in 14.4% in the statin group and in 24.6% in the no statin group (P=0.01). Multivariate logistic regression including potential univariate predictors identified statin (odds ratio [OR] =0.49; 95% confidence interval [95%CI] =0.22-0.81; P=0.01), age (OR =1.33 per 10-year increase; 95%CI =1.04-1.69; P=0.02), and transfusion (OR =2.21; 95%CI =1.38-3.55; P=0.01) as independent predictors of postoperative AF. CONCLUSIONS Preoperative statin significantly reduces the incidence of AF after elective isolated off-pump CABG in Japanese patients.