rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2015-11-5-464-469rpcardio-318Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯEfficacy of atorvastatin therapy in prevention of postoperative atrial fibrillation in patients with ischemic heart diseaseЭФФЕКТИВНОСТЬ ТЕРАПИИ АТОРВАСТАТИНОМ В ПРОФИЛАКТИКЕ ПОСЛЕОПЕРАЦИОННОЙ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦАРубаненкоО. А.RubanenkoO. A.

к.м.н., ассистент кафедры факультетской терапии СамГМУ, врач-кардиолог СОККД 

olesya.rubanenko@gmail.comСамарский государственный медицинский университет 443099, Самара, ул. Чапаевская, 89 Самарский областной клинический кардиологический диспансер 443070, Самара, ул. Аэродромная, 43РоссияSamara State Medical University. Chapaevskaya ul., 89, Samara, 443099 Russia Samara Regional Clinical Cardiology Clinic. Aerodromnaya ul., 43, Samara,443070 RussiaRussian Federation201503112015115464469Copyright © Rubanenko O.A., 20152015Рубаненко О.А.Rubanenko O.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/318Aim

Aim. To evaluate the efficacy of atorvastatin therapy in prevention of atrial fibrillation (AF) development after coronary artery bypass graft (CABG) surgery in patients with ischemic heart disease (IHD) with the assessment of inflammation, sheer stress and myocardial injury indicators. Material and methods. The study included 105 patients with IHD who were divided into two groups: patients of group 1 were treated with atorvastatin (59 patients, 81% males, mean age 62.1±7.5 years); patients of group 2 received no HMG-CoA reductase inhibitors (46 patients, 89% males, and mean age 61.7±8.1 years). 

Results

Results. Postoperative AF occurred more often in patients of group 2 (41.3% vs 16.9%; р=0.047). Laboratory analysis revealed the following: the levels of total leukocytes, interleukin-8, interleukin-10, C-reactive protein, fibrinogen, superoxide dismutase and troponin did not different significantly among the patients of two groups. Interleukin-6 level in preand postoperative period was significantly higher in patients of group 2 (35.4±28.5 pg/ml vs 24.1±14.8 pg/ml, р=0.03; 63.7±54.8 pg/ml vs 50.7±40.8 pg/ml, р=0.04, respectively). 

Conclusion

Conclusion. Our study has shown that atorvastatin therapy contributed to the reduction of number of new cases of AF after CABG in patients with IHD. At that, the efficacy of atorvastatin therapy correlated with the size of left atrium and the severity of inflammatory response. Patients with atorvastatin therapy had significantly lower interleukin-6 level, as a proinflammatory marker, in preand postoperational period as compared with the patients without such treatment.

Цель

Цель. Определить эффективность терапии аторвастатином в профилактике фибрилляции предсердий (ФП) у больных ишемической болезнью сердца (ИБС), подвергающихся операции коронарного шунтирования (КШ), с оценкой факторов воспаления, антиоксидантной активности и миокардиального повреждения. Материал и методы. Обследовано 105 пациентов с ИБС, которые распределены на 2 группы: 1 группа получала аторвастатин (59 пациентов, 81,0% мужчин, средний возраст 62,1±7,5 лет), 2 группа – не принимала ингибиторы ГМГ-Коа-редуктазы (46 пациентов, 89,0% мужчин, средний возраст 61,7±8,1 лет). 

Результаты

Результаты. ФП чаще встречалась среди больных 2 группы (41,3% против 16,9%; р=0,047). Анализ лабораторных показателей выявил следующее: уровни лейкоцитов, лейкоцитарной формулы, интерлейкина-8, интерлейкина-10, С-реактивного белка, фибриногена, супероксиддисмутазы, тропонина до и после операции между исследуемыми группами значимо не различались. Уровень интерлейкина-6 был значимо выше в преди послеоперационном периоде среди пациентов 2 группы (35,4±28,5 пг/мл против 24,1±14,8 пг/мл, р=0,03; 63,7±54,8 пг/мл против 50,7±40,8 пг/мл, р=0,04, соответственно). 

Заключение

Заключение. В нашей работе показано, что аторвастатин способствовал уменьшению новых случаев ФП после операции КШ у больных ИБС. При этом эффективность аторвастатина коррелировала с размером левого предсердия и степенью выраженности воспалительного ответа. В группе больных, принимавших аторвастатин, в преди послеоперационном периоде отмечался значимо более низкий уровень интерлейкина-6 как провоспалительного показателя при сравнении с пациентами без соответствующего лечения. 

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The authors declare that there are no conflicts of interest present.