Perbandingan Efek Protektif Atorvastatin dan Rosuvastatin Terhadap Kejadian Fibrilasi Atrium Paska Bedah Pintas Koroner

Abstract

Latar Belakang: Fibrilasi atrium paska pembedahan jantung berhubungan dengan meningkatnya resiko komplikasi, lama rawatan, dan biaya perawatan. Beberapa studi menunjukkan bahwa efek pleiotropik statin berperan sebagai anti-inflamasi dan pencegahan fibrilasi atrium. Penelitian ini bertujuan untuk membandingkan efektivitas atorvastatin dan rosuvastatin dalam mencegah kejadian FA paska bedah pintas koroner. Metode : Terdapat 53 pasien yang menjalani bedah pintas koroner di RSUP Haji Adam Malik mulai Februari hingga Agustus 2018. Pasien dirandomisasi ke dalam dua kelompok untuk menilai efek statin, yaitu kelompok yang mendapatkan atorvastatin 20 mg/hari (n=26) dan kelompok yang mendapatkan rosuvastatin 10 mg/hari (n=27). Kejadian FA paska bedah pintas koroner selama rawatan dinilai dari EKG. Data subyek dikumpulkan dan dilakukan analisa statistik untuk menilai efek protektif statin terhadap FA paska bedah pintas koroner. Hasil : Angka kejadian fibrilasi atrium paska bedah pintas koroner adalah 11,3%, dimana tidak dijumpai perbedaan bermakna antara kelompok atorvastatin dan rosuvastatin (7,7% vs 14,8%; p = 0,669). Lama rawatan di ICU dan total lama rawatan di rumah sakit lebih panjang pada kelompok pasien yang mengalami FA paska bedah pintas koroner (82,4 vs 32,2 jam, p=0,027; 10,7 vs 7,5 hari, p=0,003). Kesimpulan : Penelitian ini menunjukkan bahwa efek protektif atorvastatin 20 mg/hari sebanding dengan rosuvastatin 10 mg/hari dalam mencegah kejadian fibrilasi atrium paska bedah pintas koroner.

Background: Atrial fibrillation (AF) after cardiac surgery is associated with increased risk of complications, length of stay, and cost of care. Recent studies have demonstrated that statins have pleiotropic effects, including anti-inflammatory effects and atrial fibrillation (AF) preventive effects. The objective of this study was to assess the efficacy of preoperative statin therapy in preventing AF after coronary artery bypass grafting (CABG). Methods: 53 patients underwent CABG in our hospital from February to August 2018. Patients were randomized into two groups to examine the influence of statins: those with atorvastatin 20 mg/day during preoperative period (Atorvastatin group, n = 26) and those with rosuvastatin 10 mg/day (Rosuvastatin group, n = 27). Patient data were collected and analyzed to determine the protective effect of statins on post operative atrial fibrillation. Results: The primary end-point is postoperative AF with overall incidence of postoperative AF was 11,3%. Postoperative AF incidence was insignificantly different between atorvastatin and rosuvastatin group (7,7% vs 14,8%; p = 0,669). The secondary end-points are length of stay in ICU and total hospital stay. Accordingly, both ICU and hospital length of stay were longer in the POAF group compared to non POAF group (82,4 hours vs 32,2 hours, p=0,027; 10,7 vs 7,5 days, p=0,003). Conclusion: Our study indicated that atorvastatin had similar protective effect to rosuvastatin in term of post-operative AF prevention.