Defining the role of perioperative statin treatment in patients after cardiac surgery: A meta-analysis and systematic review of 20 randomized controlled trials

Background: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. Methods: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs). The primary endpoints included postoperative atrial fibrillation, acute kidney injury and all-cause mortality. Results: Twenty studies involving 4338 patients were included in the meta-analysis. Among the patients who underwent cardiac surgery, perioperative statin therapy was significantly associated with a decreased risk of postoperative atrial fibrillation (OR: 0.50; P = 0.0004), particularly in the subgroup of patients who used atorvastatin and those who underwent isolated coronary artery bypass grafting (CABG) surgery. Moreover, perioperative statin use significantly decreased the length of hospital stay (weighted mean difference (WMD): -0.43; P = 0.002). However, no reductions were observed in acute kidney injury, myocardial infarction, postoperative serum creatinine concentration or the length of intensive care unit (ICU) stay. Conclusions: Perioperative statin therapy might be promising for the prevention of postoperative atrial fibrillation following cardiac surgery, especially for patients undergoing isolated CABG surgery or atorvastatin administration. Additionally, statin use can decrease the length of the hospital stay. (C) 2016 Published by Elsevier Ireland Ltd.