Preoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery

Objective: To determine if preoperative statin treatment is associated with a reduction in systemic inflammatory response (SIR) and myocardial damage markers following cardiac surgery with cardiopulmonary bypass (CPB). Methods: We study a prospective cohort of 138 patients who underwent coronary and valvular surgery with CPB. We differentiate two study groups: patients with (group A, n = 72) or without (group B, n = 66) statins. Plasma levels of pro-inflammatory interleukins (tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-8 and IL-2R), creatine phosphokinase (CPK), CPK-MB and troponin I were measured before and 1, 6, 24 and >72 h after surgery. Results: The baseline, operative and postoperative morbidity and mortality characteristics were similar for both the groups. Group A had significantly lower postoperative levels of IL-6 than group B at 6 h (68.8 +/- 5 pg ml(-1) vs 108.9 +/- 108 pg ml(-1), p = 0.01), 24 h (71.7 +/- 7 pg ml(-1) vs 110.4 +/- 106 pg ml(-1), p = 0.01) and before hospital discharge (21.6 +/- 12 pg ml(-1) vs 32.8 +/- 27 pg ml(-1), p = 0.005), as well as significantly lower average IL-6 levels in the first 24 h following surgery (71.8 +/- 5 pg ml(-1) vs 112.8 +/- 82 pg ml(-1), p = 0.002). The postoperative CPK-MB at 24 h (19.7 +/- 23 ng ml(-1) vs 33.1 +/- 32 ng ml(-1), p = 0.02) and troponin 1 levels at the end of the intervention (2.2 +/- 2.2 ng ml(-1) vs 3.3 +/- 3.1 ng ml(-1), p = 0.03) and at 24 h (4.1 + 3.5 ng ml(-1) vs 6.6 +/- 8 ng ml(-1), p = 0.04) were also significantly lower in the group treated with statins prior to surgery. Conclusions: Preoperative treatment with statins is associated with a lower biochemical parameters of SIR and myocardial damage following cardiac surgery with CPB, regardless of it being coronary bypass grafting (CABG) or valvular surgery. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.