Key result
Combination prophylaxis with oral atorvastatin plus vitamin C significantly reduced the occurrence of post-CABG atrial fibrillation compared to atorvastatin alone (10% vs 25%, OR 0.33).
Why the study?
Does combination therapy with atorvastatin and vitamin C reduce the occurrence of post-CABG atrial fibrillation in patients undergoing CABG compared to atorvastatin alone?
RCT (n=120)
Double-blind
Randomized
No
Does combination therapy with atorvastatin and vitamin C reduce the occurrence of post-CABG atrial fibrillation in patients undergoing CABG compared to atorvastatin alone?
Combination prophylaxis with oral atorvastatin and vitamin C significantly reduces the incidence of post-CABG atrial fibrillation compared to atorvastatin alone.
Supports adding vitamin C to atorvastatin for post-CABG AF prevention; extends statin evidence with a low-cost adjunct in cardiac surgery.
PURPOSE: Atrial fibrillation (AF) is the most frequent arrhythmia that follows coronary artery bypass graft (CABG). Patients developing postoperative AF (POAF) have significantly higher mortality rates. The consistent prophylactic effectiveness of statins and vitamin C are well-accepted; however, no evaluation on combined therapy has been performed. We aimed at assessing the efficacy of combination therapy with statin and vitamin C in comparison with statin alone in the prevention of post CABG-AF. METHODS: In a randomized double blind clinical trial, 120 candidates of CABG were recruited in Tabriz Madani Educational Center in a 15-month period of time. Patients were randomized into two groups of 60 receiving oral atorvastatin (40mg) plus oral vitamin C (2g/d operation day and 1g/d for five consequent days) for intervention group and oral atorvastatin (40mg) for control group. Occurrence of post CABG AF was compared between the two groups. RESULTS: There were 60 patients, 43 males and 17 females with a mean age of 61.0±11.5 (29-78) years, in the intervention group and sixty patients, 39 males and 21 females with a mean age of 60.5±11.3 (39-81) years, in the control group. The post CABG AF occurred in 6 cases (10%) in the interventional group and 15 patients (25%) in the controls (P=0.03, odds ratio=0.33, 95% confidence interval 0.12-0.93). CONCLUSION: Based on our findings, combination prophylaxis against post CABG AF with oral atorvastatin plus vitamin C is significantly more effective than single oral atorvastatin.
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Samadikhah et al. (2013) conducted an RCT in Post-CABG Atrial Fibrillation (n=120). Atorvastatin plus Vitamin C vs. Atorvastatin 40 mg/day plus placebo was evaluated on Occurrence of post-CABG atrial fibrillation (OR 0.33, 95% CI 0.12-0.93, p=0.03). Combination prophylaxis with oral atorvastatin plus vitamin C significantly reduced the occurrence of post-CABG atrial fibrillation compared to atorvastatin alone (10% vs 25%, OR 0.33).
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