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AIMS: Systemic inflammation and increased activity of atrial NOX2-containing NADPH oxidases have been associated with the new onset of atrial fibrillation (AF) after cardiac surgery. In addition to lowering LDL-cholesterol, statins exert rapid anti-inflammatory and antioxidant effects, the clinical significance of which remains controversial. METHODS AND RESULTS: We first assessed the impact of cardiac surgery and cardiopulmonary bypass (CPB) on atrial nitroso-redox balance by measuring NO synthase (NOS) and GTP cyclohydrolase-1 (GCH-1) activity, biopterin content, and superoxide production in paired samples of the right atrial appendage obtained before (PRE) and after CPB and reperfusion (POST) in 116 patients. The effect of perioperative treatment with atorvastatin (80 mg once daily) on these parameters, blood biomarkers, and the post-operative atrial effective refractory period (AERP) was then evaluated in a randomized, double-blind, placebo-controlled study in 80 patients undergoing cardiac surgery on CPB. CPB and reperfusion led to a significant increase in atrial superoxide production (74% CI 71-76%, n = 46 paired samples, P 

Original publication

DOI

10.1093/cvr/cvaa302

Type

Journal article

Journal

Cardiovasc Res

Publication Date

07/01/2022

Volume

118

Pages

184 - 195

Keywords

Atorvastatin, Atrial refractory period, Clinical trial, Ischaemia-Reperfusion Injury, Nitric Oxide Synthase, Oxidant stress, Postoperative Atrial fibrillation, Action Potentials, Atorvastatin, Atrial Fibrillation, Atrial Function, Right, Biopterin, Cardiac Surgical Procedures, Cardiopulmonary Bypass, Double-Blind Method, England, Heart Atria, Heart Rate, Humans, NADPH Oxidases, Nitric Oxide Synthase, Nitroso Compounds, Oxidation-Reduction, Refractory Period, Electrophysiological, Superoxides, Time Factors, Treatment Outcome