Anti Inflammatory Effects of Statins in Cardiac Surgery Patients

A. Raza, S. Kennedy, Y. Fan, B. Maher, M. Codd, T. Murphy, A. Wood, W. Watson

Prof. Eoin O’Malley National Centre for Cardiothoracic Surgery Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
UCD School of Medicine and Medical Sciences UCD Conway Institute and Mater Misericordiae University Hospital University College Dublin, Dublin, Ireland.

DOI: 10.4236/wjcs.2012.23010                

Abstract

Objectives: Cardiac surgery with cardiopulmonary bypass provokes systemic inflammatory response, which may cause organ dysfunction. Studies have suggested that pre-operative statin therapy can reduce morbidity and mortality associated with cardiac surgery; the mechanism for this remains unclear. We hypothesise that underlying mechanism of action for these effects of statins is through inhibition of neutrophil transendothelial migration. Methods: We recruited 151 patients undergoing cardiac surgery. Of these 41 patients were on no-statin; 48 patients on low-dose (10 - 30 mg) and 62 patients were on high-dose statin (40 - 80 mg). Ex vivo neutrophil migration was performed on pre-operative blood samples of 90 patients. Of these 90 patients we used 36 patients to assess the levels of TNF-α and sICAM-1. Clinical parameters of total 151 patients were assessed to analyse outcome. Results: Ex vivo neutrophil migration was decreased in high-dose statin group when compared to neutrophils isolated from no-statin or low-dose statin groups (p < 0.001). Serum TNF-α levels were lower in the high-dose statin group (p = 0.002) and sICAM-1 levels were decreased in both low (p = 0.02) and high-dose statin (p = 0.01) groups. Conclusion: Our study demonstrates that high-dose statins reduce ex-vivo transendothelial neutrophil migration, TNF-α and sICAM-1 serum levels suggesting that statins may help in decreasing the post-cardiac surgery morbidity.

Keywords

Statins; Neutrophils; Cardiac Surgery; Outcome; TNF-α; sICAM-1

Conflicts of Interest

The authors declare no conflicts of interest.

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