SUMMARY The use of statins was significantly associated with a decreased risk of atrial fibrillation in patients with sinus rhythm .
PURPOSE OF REVIEW Whether statins may prevent  atrial fibrillation  remains a subject of debate .
Pravastatin immunomodulates IL-6 and C-reactive protein, but not IL-1 and TNF-alpha, in cardio-pulmonary bypass.
BACKGROUND While statins are increasingly used in cardiopulmonary bypass ( CPB ) , the anti-inflammatory effects of individual statins , within the context of various treatment regimes , need further examination . The present study evaluates the anti-inflammatory effectiveness of the short-term , preoperative and intensive postoperative use of pravastatin in CPB . METHOD Forty three patients undergoing CPB were enrolled in a r and omized , prospect i ve clinical study . One group ( n = 21 ) , received pravastatin , the other ( n = 22 ) did not . Patients in the pravastatin group received one dose of 40 mg per day for nine days , starting 48 hours before CPB , with an additional dose of 40 mg one hour after surgery . Plasma levels of selected inflammatory mediators were measured at baseline and tracked systematic ally . RESULTS Pravastatin reduced postoperative interleukin-6 ( IL-6 ) levels significantly at 24 and 48 hours , and at seven days . Mean + /- SD values , for treated versus untreated patients were : at 24 hours , 159.5 + /- 58.5 versus 251.2 + /- 53.0 pg/mL ( p < 0.001 ) ; at 48 hours , 81.9 + /- 31.5 versus 194.2 + /- 56.3 pg/mL ( p < 0.001 ) ; and at seven days , 16.4 + /- 7.2 versus 30.8 + /- 12.6 ( p < 0.001 ) . C-reactive protein ( CRP ) decreased significantly on the seventh postoperative day , when plasma levels were 3.6 + /- 1.1 in the treated patients versus 8.2 + /- 2.1 mg/dL in the controls ( p < 0.001 ) . No changes in plasma IL-1 and TNF-alpha were found during entire study . CONCLUSIONS Pravastatin induced a precocious modulation of IL-6 expression and a later reduction of plasma CRP levels .  Pravastatin;s effects on the expression of these pivotal inflammatory mediators strongly support its well-timed use in CPB
SUMMARY The use of statins was significantly associated with a decreased risk of atrial fibrillation in patients with sinus rhythm .
PURPOSE OF REVIEW Whether statins may prevent  atrial fibrillation  remains a subject of debate .