| Objective:To evaluate the efficacy of atorvastatin calcium in the prevention of postoperative atrial fibrillation(POAF)after cardiac valve operation during the perioperative period,and explore independent predictors of POAF.Methods:A total of 603 consecutive adult patients requiring cardiac surgery at theDepartment of Cardiac Surgery of the First Affiliated Hospital of Kunming Medical University from January 2019 to January 2020 were analyzed.A total of 88 patients were included in the inclusion and exclusion criteria,including 33 males(37.5%),55 females(62.5%).All subjects were randomly and blindly divided into 3 study groups:31 cases(35.2%)in the low-dose group(20mg/d),30 cases(34.1%)in the high-dose group(80mg/d),and 27 cases in the blank control group.(30.7%),in addition to conventional treatment,the corresponding dose of atorvastatin calcium tablets was administered orally before bed at least 3 days before surgery according to the corresponding group.The main observational index was whether POAF occurred,and a binary logistic regression model was used to explore independent predictors of POAF occurrence.The secondary observation indicators were serum CRP levels immediately after entering the monitoring room,24h and 72h postoperatively,and the relationship between POAF occurrence and postoperative serum CRP levels was analyzed.Results:1)There was no significant difference in general clinical data between the three groups(p>0.05).2)Main observational indicators:Among all 88 subjects,45 had POAF,and the overall prevalence was 51.1%.The three groups were compared at the same time and the difference was statistically significant(χ2=10.9,p=0.004).The pairwise comparison between the groups showed that the difference in risk of POAF between the high-dose group and the low-dose group was statistically significant(χ2=8.795,p=0.003),the difference in risk of POAF between the high-dose group and the blank control group was also statistically significant(χ2=7.603,p=0.006),while the risk of POAF between the low-dose group and the blank control group was not statistically significant(χ2=0.015,p=0.902).For the two outcomes of POAF,the differences in distribution of age(U=676.0,p=0.015),LAD(U=523.0,p<0.001),and mechanical ventilation time(U=357.0,p<0.001)were statistically significant.There was no significant difference in the other variables(p>0.05).In the binary logistic regression(input method)analysis,the application of high-dose atorvastatin calcium,age,and LAD were significantly related to the occurrence of POAF,which could be used as independent predictors of POAF.3)Secondary observational indicators:Comparing serum CRP levels after surgery,it was found that there was a statistically significant difference in the distribution of serum CRP levels between the high-dose group and the low-dose group immediately after surgery to 72 hours postoperatively(p<0.017).The distribution of the high-dose group and the blank control group was statistically significant(p<0.017),while the distribution of the small-dose group and the blank control group was not statistically significant(p>0.017).Regarding whether there were two outcomes of POAF,the serum CRP levels were compared after surgery,and the results showed that the distribution difference was statistically significant(p<0.05).The serum CRP levels of subjects with POAF after surgery were significantly higher than those without POAF.Conclusions:1)Application of high-dose atorvastatin calcium(80mg/d)during the perioperative period can effectively prevent the occurrence of POAF in heart valve surgery and can effectively reduce the postoperative serum CRP level;2)Age and LAD are independent risk factors for POAF in heart valve surgery.The older the Age and the larger the LAD,the higher the prevalence of POAF;3)The higher the serum CRP level after heart valve surgery,the higher the prevalence of POAF. |
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