Preoperative Statin Use Is Associated With Less Postoperative Atrial Fibrillation After Myectomy in Patients With Hypertrophic Obstructive Cardiomyopathy

Abstract

The present study aims to investigate whether preoperative statin use is associated with less postoperative atrial fibrillation occurrence after septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM). Clinical data of consecutive patients with HOCM who underwent septal myectomy between February 2009 and May 2019 at our institution was retrospectively reviewed. The cohort was divided into 2 groups according to the status of preoperative statin use (statin group vs no statin group). Logistic regression was used to explore associations of clinical variables with postoperative atrial fibrillation occurrence. A total of 1307 patients with HOCM underdoing septal myectomy were included in the present study, with 109 patients in the statin group and 1198 in the no statin group. Among 322 patients (24.6%) developing postoperative atrial fibrillation, 21 cases (19.3%) occurred in the statin group, while 301 cases (25.1%) were in the no statin group (P = 0.202). After propensity score matching with confounding variables at baseline, 91 paired patients were included in the matched cohort. Postoperative atrial fibrillation developed in 17 (18.7%) and 38 (41.8%) in the statin and no statin groups, respectively (P = 0.001). Preoperative statin use was associated with less postoperative atrial fibrillation occurrence (odds ratio 0.220, 95% confidence interval 0.083-0.588, P<0.003). The present study suggested that preoperative statin use was associated with less postoperative atrial fibrillation occurrence after septal myectomy in patients with HOCM. This finding may provide clues for subsequent prospective study to investigate this clinical issue.

Keywords: Hypertrophic obstructive cardiomyopathy; Postoperative atrial fibrillation; Septal myectomy; Statin.