Impact of Perioperative High-Intensity Statin Use on New-Onset Atrial Fibrillation After Aortic Valve Replacement

Background: There have been controversial data about whether the use of statins is beneficial in preventing postoperative atrial fibrillation (PO[AF]). This study evaluated the impact of perioperative statin use on the occurrence of POAF after aortic valve replacement (AVR). Methods: A retrospective review was conducted of 507 patients (292 men, 215 women) who underwent AVR, with or without ascending aortic surgery, from January 2018 to October 2023. Patients who underwent concomitant valve surgery other than AVR or patients with preoperative AF were excluded. Median age at the operation was 68 years, (interquartile range, 62-75 years). All patients were continuously telemonitored to detect AF after surgery until discharge. Any occurrence of AF that lasted for at least 30 seconds during the hospital stay was defined as POAF. Early outcomes were evaluated, and perioperative factors associated with POAF were analyzed using a multivariable logistic regression model. Results: The early mortality rate was 1.4% (7 of 507 patients). POAF occurred in 175 patients (34.5%). Univariate analyses demonstrated that perioperative use of a high-intensity statin (atorvastatin ≥40 mg or rosuvastatin 20 mg) as well as age, hypertension, history of stroke, chronic kidney disease, type of prosthesis, and perioperative use of a β-blocker were associated with the occurrence of POAF. The multivariable model showed that not postoperative use of a statin but the use of a high-intensity statin after AVR was a preventive factor of POAF (odds ratio, 0.363; 95% CI, 0.142-0.928). Conclusions: Use of a high-intensity statin might be effective in preventing POAF after AVR.