Pretreatment with atorvastatin 20 mg/day for 3 weeks before coronary bypass surgery significantly reduced postoperative peak levels of IL-6, IL-8, and neutrophil adhesion compared with placebo.
RCT (n=40)
Double-blinded
Randomized
No
Does preoperative atorvastatin 20 mg/day reduce systemic inflammatory response and perioperative morbidity in patients undergoing coronary artery bypass grafting?
Preoperative atorvastatin reduces surrogate markers of systemic inflammation after cardiopulmonary bypass, though it did not significantly alter short-term clinical perioperative morbidity in this small study.
OBJECTIVES: Systemic inflammatory response occurs frequently after coronary artery bypass surgery, and it is strongly correlated with the risk of postoperative morbidity and mortality. Recent studies demonstrate that treatment with statin is associated with a significant and marked decrease in inflammation-associated variables such as the C-reactive protein, cytokines, and adhesion molecules. Therefore, we investigated the effects of preoperative atorvastatin treatment on systemic inflammatory response and perioperative morbidity after cardiopulmonary bypass. DESIGN: Double-blinded, placebo-controlled, randomized study. SETTING: University hospital. PATIENTS: Forty patients were randomized to treatment with atorvastatin (20 mg/day, group A, n=20) or placebo (group B, n=20) 3 wks before surgery. INTERVENTIONS: Three-week treatment by atorvastatin 20 mg/day. MEASUREMENT AND MAIN RESULTS: Postoperative serum levels of both interleukin-6 and interleukin-8 increased significantly over baseline, but the peak levels observed 4 hrs postoperatively were significantly lower in the atorvastatin group. In the same fashion, CD11b expression on neutrophils was significantly lower in the statin group at 4 and 24 hrs postoperatively. Finally, neutrophil-endothelial adhesion was significantly reduced in the statin patients compared with controls. The operation time, blood loss, need for inotropic support, intubation time, and length of intensive care unit or hospital stay did not differ significantly between the two groups. The systemic inflammatory response syndrome score on postoperative days 1 and 2 was comparable in both groups. CONCLUSIONS: Pretreatment with atorvastatin significantly reduces cytokine release and neutrophil adhesion to the venous endothelium in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.
Chello et al. (Wed,) conducted a rct in Coronary artery bypass surgery (n=40). Atorvastatin vs. Placebo was evaluated on Systemic inflammatory response (postoperative serum levels of interleukin-6 and interleukin-8, CD11b expression, and neutrophil-endothelial adhesion). Pretreatment with atorvastatin 20 mg/day for 3 weeks before coronary bypass surgery significantly reduced postoperative peak levels of IL-6, IL-8, and neutrophil adhesion compared with placebo.