[Effects of statins on postoperative treatment of patients after aortocoronary bypass grafting]. 2009

Mehmed Kulić, and Mirza Dilić, and Vjekoslav Gerc, and Bećir Heljić
Kardioloski odjel, Centar za srce, Klinicki centar Univerziteta u Sarajevu, Bosna i Hercegovina.

OBJECTIVE There are no previous data about the anti-inflammatory effects of hypolipemic agents, statins, in patients after aortocoronary bypass grafting. The aim of this study was to demonstrate effects of simvastatine on postoperative treatment, laboratory findings and pericardial effusion during postoperative period, in patients after aortocoronary bypass grafting procedures. METHODS The study included 80 patients with coronary arterial disease divided in two groups. The study group included 40 patients with coronary ischemic disease subjected to surgical implantation of aortocoronary bypass graft who received standard cardio-surgical postoperative treatment supplemented with 40 mg of simvastatine per day, starting at 8 hours after the patient's extubation until postoperative 14th day. The control group included 40 patients after aortocoronary bypass grafting procedures with standard intensive postoperative treatment. Evaluation included demographic data, surgical reports, postoperative laboratory parameters and echocardiography findings, taken during two days monitoring of postoperative pericardial effusion. Statistical data analysis was conducted using SPSS software. Parametric data were evaluated using Student T-test, while non-parametric data were processed using chi2 test and proportion analysis. Mann-Whitney U test was applied with CI of 95%, i.e., significance level p < 0.05. RESULTS No significant differences were found between the observed groups with regards to demographic data, number of the implanted aortocoronary bypasses and postoperative laboratory parameters. However, the differences in echocardiographically determined dimensions of postoperative pericardial effusions measured during two days of postoperative observation (between the 3rd and the 14th day postoperative) were significant (p < 0.037, p < 0.01). CONCLUSIONS In our study, statin therapy consisting of 40 mg/24 hrs was applied with no side effects and without interaction with the other postoperatively applied medications. Simvastatins, applied in the dosage of 40 mg/24 hrs, efficiently lead to significant reduction of postoperative pericardial effusions in postoperative period. In this limited group of patients, statins have exhibited good anti-inflammatory effects. Statins with standard therapy ought to be included in the early cardio-surgical postoperative period. Anti-inflammatory activities of statins should be further investigation on much larger patient sample. So far, there is no record of a large study of anti-inflammatory activities of hypolipemic agents that could waive the doubts into their effectiveness. It needs to be stressed that no large studies of anti-inflammatory activities of hypolipemic agents in cases of postoperative pericardial effusion were ever conducted.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D003327 Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. Coronary Heart Disease,Coronary Diseases,Coronary Heart Diseases,Disease, Coronary,Disease, Coronary Heart,Diseases, Coronary,Diseases, Coronary Heart,Heart Disease, Coronary,Heart Diseases, Coronary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D019161 Hydroxymethylglutaryl-CoA Reductase Inhibitors Compounds that inhibit HYDROXYMETHYLGLUTARYL COA REDUCTASES. They have been shown to directly lower CHOLESTEROL synthesis. HMG-CoA Reductase Inhibitor,HMG-CoA Reductase Inhibitors,Hydroxymethylglutaryl-CoA Reductase Inhibitor,Statin,Statins, HMG-CoA,Inhibitors, HMG-CoA Reductase,Inhibitors, Hydroxymethylglutaryl-CoA,Inhibitors, Hydroxymethylglutaryl-Coenzyme A,Statins,HMG CoA Reductase Inhibitor,HMG CoA Reductase Inhibitors,HMG-CoA Statins,Hydroxymethylglutaryl CoA Reductase Inhibitor,Hydroxymethylglutaryl CoA Reductase Inhibitors,Hydroxymethylglutaryl-CoA Inhibitors,Hydroxymethylglutaryl-Coenzyme A Inhibitors,Inhibitors, HMG CoA Reductase,Inhibitors, Hydroxymethylglutaryl CoA,Inhibitors, Hydroxymethylglutaryl Coenzyme A,Inhibitors, Hydroxymethylglutaryl-CoA Reductase,Reductase Inhibitor, Hydroxymethylglutaryl-CoA,Reductase Inhibitors, HMG-CoA,Reductase Inhibitors, Hydroxymethylglutaryl-CoA,Statins, HMG CoA

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