Cited by 105Cardiac and Coronary Surgery TechniquesLipoproteins and Cardiovascular HealthCancer, Stress, Anesthesia, and Immune Response

Simvastatin increases neutrophil apoptosis and reduces inflammatory reaction after coronary surgery.

Chello, Massimo, Anselmi, Amedeo, Spadaccio, Cristiano, Patti, Giuseppe, Goffredo, Costanza, Di Sciascio, Germano, Covino, Elvio·2007·The Annals of Thoracic Surgery

Abstract

Background Neutrophils play a central role in systemic inflammatory reaction after cardiopulmonary bypass. Apoptosis is significantly delayed, and this might exacerbate systemic and myocardial damage. We tested the hypothesis of whether pretreatment with simvastatin increases the apoptotic rate of neutrophils and hence reduces the entity of inflammatory reaction.Methods Thirty patients undergoing coronary surgery with cardiopulmonary bypass were randomized to treatment with either simvastatin (40 mg/day) or placebo for 3 weeks before surgery. A group of 15 patients undergoing off-pump coronary surgery served as controls. Blood samples for detection of serum cytokine levels were obtained before anesthesia, at the end of surgery, and at 4, 24, 48, and 72 hours postoperatively. Apoptosis and indices of activation were assessed in cultured neutrophils.Results Simvastatin significantly reduced the postoperative peak values of interleukin (IL)-6 and IL-8. The neutrophil apoptotic rate was significantly higher among neutrophils obtained from patients pretreated with simvastatin (p < 0.05 at both 8 and 24 hours) compared with placebo. Neutrophils from the statin group had depressed functional activity, as underscored by significantly lower values of CD11b (p < 0.01 at 24 hours) and a significantly less percentage of cells positive for nitro-blue tetrazolium (p < 0.01 at 12 and 24 hours) compared with placebo.Conclusions This randomized, double-blind study indicates that statin therapy before cardiopulmonary bypass is associated with reduction of circulating markers of inflammation and increased neutrophil apoptosis. These data support a routine inclusion of statins as an adjuvant pharmacologic therapy before cardiopulmonary bypass surgery.

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Crossref · 10.1016/j.athoracsur.2006.10.065

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Authors
Chello, M., Anselmi, A., Spadaccio, C., Patti, G., Goffredo, C., Di Sciascio, G., & Covino, E.
Affiliations
Università Campus Bio-Medico (IT)
Corresponding author
Chello, Massimo
Venue
The Annals of Thoracic Surgery
Publisher
Elsevier BV
Published
2007-04
Volume
83
Issue
4
Pages
1374-1380
ISSN
0003-4975 (ISSN-L)
OpenAlex
W2165560542
Cited by
105
References
26
Citations by year
2026: 4 · 2025: 6 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 2 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 8 · 2015: 7 · 2014: 3 · 2013: 4 · 2012: 8
FWCI
10.96
Type
journal article
Language
en
Open access
closed
Locations
  • The Annals of Thoracic Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
Keywords
simvastatin, statins, neutrophil apoptosis, systemic inflammatory response, cardiopulmonary bypass, coronary artery surgery, interleukin-6, interleukin-8, CD11b, nitroblue tetrazolium, preoperative statin therapy, adjuvant pharmacotherapy
MeSH terms
Aged, Coronary Artery Bypass, Coronary Disease, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Complications, Preoperative Care, Probability, Reference Values, Severity of Illness Index, Survival Rate, Cytokines, Treatment Outcome, Coronary Angiography, Apoptosis, Neutrophil Activation, Risk Assessment, Systemic Inflammatory Response Syndrome, Simvastatin

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