Impact of pre-operative statin use on risk of mortality and early atrial fibrillation after heart transplantation

Background: Pre-operative statin use has shown to reduce the incidence of post-operative atrial fibrillation (AF), but not mortality in patients undergoing cardiac surgery. This association, however, has not been examined in a heart transplant (HT) cohort. Methods: Adults (≥18 yr) who underwent HT between 1997 and 2007 at the University of Minnesota were retrospectively identified. Primary outcome was 30-d mortality after HT. Secondary outcomes were 30-d incidence of AF and time to all-cause mortality. Results: Data from 259 patients (mean age 52.0 ± 11.7 yr, 81% males) were analyzed. Total of 133 (51%) patients were on statin pre-operatively at the time of HT and constituted the statin group. During a mean follow-up of 6.7 ±3.7 yr, 82 (32%) deaths occurred, 21 (8%) of which occurred within 30 d of HT. The incidence of 30-d mortality was not significantly different between the statin and no-statin groups (9% vs. 7%, p = 0.58). Further, cumulative long-term survival after HT was not significantly different between the study groups (log-rank p = 0.49). Pretransplant statin use did not impact the 30-d incidence of post-transplant AF (16% vs. 19%, p = 0.59). Conclusions: Pre-operative statin therapy does not seem to influence the risk of mortality or early post-operative AF after HT. Future large-scale studies are required to validate these preliminary findings.