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Can Statins Reduce the Inflammatory Response to Cardiopulmonary Bypass? A Clinical Study
Author(s) -
Florens Emmanuelle,
Salvi Susanna,
Peynet Jacqueline,
Elbim Carole,
Mallat Ziad,
Bel Alain,
Nguyen Alix,
Tedgui Alain,
Pasquier Catherine,
Menasché Philippe
Publication year - 2001
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2001.tb00513.x
Subject(s) - medicine , cardiopulmonary bypass , atorvastatin , statin , inflammation , anesthesia , cardiology , gastroenterology
A bstractObjective: In addition to lowering lipid levels, statins might reduce leukocyte‐endothelial cell interactions. Therefore, we assessed whether this effect could limit the inflammatory response to cardiopulmonary bypass (CPB) in cardiac surgical patients. Methods: Twenty patients undergoing valve or coronary operations with tepid (34°C) CPB were randomized to receive an oral dose of atorvastatine (40 mg the evening before and 40 mg the morning of surgery) or to serve as controls. Pre‐ and post‐CPB blood samples were assayed for neutrophil CD11b surface adhesion molecule and oxidative burst. Plasma levels of interleukins 6 and 8, P‐selectin, soluble intercellular adhesion molecule‐1, and lactoferrin were measured by enzyme‐linked immunosorbent assay (ELISA). In addition, right atrial biopsies were taken before and at the end of CPB, and processed for the expression of the transcription nuclear factor‐kappa B (NF‐κB). Results: The two groups did not differ with regard to pre‐ and introoperative data. Except for P‐selectin, postbypass values of all markers significantly increased over baseline values, but atorvastatin therapy failed to attenuate the magnitude of this increase. In the two groups, the expression of NF‐κB significantly (p = 0.004) increased over baseline without group effect. Postoperative clinical outcomes did not differ either between the two groups. Conclusion: These data show that acute preoperative statin therapy fails to limit the inflammatory response to CPB; however, the data also document a major upregulation of NF‐κB during cardiac operations, thereby providing a sound rationale for interventions targeted at inactivating this key component of the inflammatory cascade.