Objective:
Comparison of the Preconditioning Effect of High Dose and Low Dose of Atorvastatin in CABG.
Study design: Triple-blind, randomized, clinical trial.
Method:100 Patients who were undergoing on-pump coronary artery bypass graft (CABG) divided into two groups of A and B. 50 patients assigned in the intervention group and 50 patients in the control group.
Inclusion criteria:
Patients who had been taking (atorvastatin 20 mg daily) at least one year prior to the cardiac surgery.
Exclusion criteria:
Unstable angina; evidences of recent MI (within 6 months) ; history of cardiac surgery; congenital heart disease; history of cardiac arrhythmias (arterial fibrillation) before surgery; receiving anti- arrhythmic drugs (except Beta blockers) ; having pacemaker; left ventricle ejection fraction less than 30%, uncontrolled hypertension; arterial or ventricular arrhythmia; pregnancy; patient who are undergoing diabetes treatment; increased level of liver enzymes; renal failure with creatinine more than 2 mg/dl; active inflammation or immune deficiency; positive history of muscle disease or reaction to the stations.
Intervention:
Patients in the study group received 80 mg atorvastatin daily, for 3 days before surgery and low dose of 20 mg atorvastatin daily during the ICU stay, after surgery, and after discharge, the treatment continued at home with a single dose of 20 mg atorvastatin daily. On the other side, patients in the control group received 20 mg atorvastatin up to surgery and during the one month follow up period, they continued their medication with 20 mg atorvastatin daily. While, single dose of atorvastatin was given to the patients every night, an hour after the meal.
The primary outcomes: troponin I, creatinine kinase-MB (CK-MB) and high-sensitivity C-reactive protein (hs-CRP) levels, the incidence of postoperative arrhythmia and ventricular fibrillation, mechanical ventilation duration in the ICU.
Secondary outcomes: DC shock frequency, ICU length of stay, ejection fraction level, ICU blood intake, need for inotrope at the pomp off time or in the ICU, blood glucose, liver status glomerular filtration rate (GFR) and urine output.