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