Conditions: Acute Kidney Injury Post-Operative Delirium Icu Delirium Acute Renal Failure Delirium
Keywords: aki delirium statin short-term cardiac
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 653
Healthy volunteers: no

Brief summary:
Aim1a: Statin naive patient's scheduled for cardiac surgery will be randomized to 80mg atorvastatin or placebo on the day prior to surgery and then 40mg daily thereafter until hospital discharge to test the hypothesis that short-term atorvastatin use decreases:

1. acute kidney injury following cardiac surgery.
2. postoperative delirium following cardiac surgery.

Aim1b: Patients using statins preoperatively will be randomized to atorvastatin 80mg or placebo on day of surgery and 40mg or placebo on postop day 1 with resumption of preoperative statin therapy on postop day 2 to test the hypothesis that short-term atorvastatin use decreases:

1. acute kidney injury following cardiac surgery.
2. postoperative delirium following cardiac surgery.

Endpoints include glomerular filtration, urine and plasma markers of renal dysfunction, markers of oxidative stress, mitochondrial function, systemic inflammatory markers, delirium, dialysis, stroke, myocardial infarction, time to extubation, ICU length of stay, and death.

Detailed description:

Arms:
arm 1: Aim1 intervention: atorvastatin 80mg 1 day prior to open heart surgery and 40mg daily thereafter until hospital discharge.

Aim2 intervention: atorvastatin 80mg the day of cardiac surgery and 40mg on postop day 1. arm 2: Aim 1 control: placebo one day prior to cardiac surgery and daily thereafter until hospital discharge.

Aim 2 control: placebo the day of cardiac surgery and postop day 1.

Interventions: intervention 1: atorvastatin intervention 2: placebo
Intervention descriptions: intervention 1: Aim1 intervention: atorvastatin 80mg 1 day prior to open heart surgery and 40mg daily thereafter until hospital discharge.

Aim2 intervention: atorvastatin 80mg the day of cardiac surgery and 40mg on postop day 1. intervention 2: Aim 1 control: placebo one day prior to cardiac surgery and daily thereafter until hospital discharge.

Aim 2 control: placebo the day of cardiac surgery and postop day 1.

Protocol document: