對將接受心髒手術患者進行他汀預處理可預防患者術後心房顫動(簡稱房顫)。但上述結論是基於觀察性和有限的隨機試驗證據，他汀類藥物的這一益處在臨床實際應用中如何?多國學者對此進行了聯合薈萃分析，結果表明，短期他汀預處理可能減少心髒手術患者術後房顫風險。相關論文近期發表於Europace雜誌。

研究者們詳細檢索了MEDLINE和PubMed數據庫，審閱了已發表研究的參考文獻列表並聯係參與試驗者，以獲取薈萃分析中的個體參與者數據。證據組合來源於前瞻性隨機臨床研究，這些研究均對比了在擇期心髒手術之前，接受他汀預處理或安慰劑/對照藥物治療的患者術後房顫風險。以房顫持續發作時間≥5分鍾定義為術後房顫。

結果顯示，共納入了11項試驗中的1105例受試者，其中，552例接受了術前他汀治療。接受和未接受他汀預處理患者的術後房顫發生率分別為19%和36%(比值比0.41，P < 0.00001)。他汀預處理預防房顫的作用在不同亞組人群中也一致。

參考文獻：Patti G, et al. Europace.2015 Mar 1. pii: euv001. [Epub ahead of print]

Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials.
Patti G1, Bennett R2, Seshasai SR2, Cannon CP3, Cavallari I1, Chello M1, Nusca A1, Mega S1, Caorsi C4, Spadaccio C5, Keun On Y6, Mannacio V7, Berkan O8, Yilmaz MB9, Katrancioglu N9, Ji Q10, Kourliouros A11, Baran Ç12, Pasceri V13, Rüçhan Akar A12, Carlos Kaski J2, Di Sciascio G1, Ray KK14.

Abstract
AIMS:
Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF). However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine anti-arrhythmic benefits of these agents in this setting. We therefore aimed to quantify precisely the association between statin pretreatment and postoperative AF among patients undergoing cardiac surgery.
METHODS AND RESULTS:
A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012) was conducted, followed by a review of the reference lists of published studies and correspondence with trial investigators to obtain individual-participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting ≥5 min.
Overall, 1105 participants from 11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval 0.31-0.54, P < 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatment was consistent across different subgroups.
CONCLUSION:
Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery.