Effects of Preoperative Statin Therapy on Cytokines after Cardiac Surgery

Abstract

Introduction: In addition to their lipid-lowering action, it has been demonstrated that statins can exert direct anti-inflammatory effects. We investigated the effect of preoperative statin therapy on systemic inflammatory markers and myocardial NF-κB inhibitor IκB-α after cardiac surgery. Methods: Thirty-six patients undergoing elective coronary artery bypass grafting with cardiopulmonary bypass (CPB) with cardioplegia were divided into two groups (statin group, n = 18; control group, n = 18). Plasma concentrations of pro-inflammatory cytokines (tumor necrosis factor α [TNFα], interleukin [IL]-6, IL-8) and anti-inflammatory IL-10 were measured before and 1, 4, 10, and 24 hours (h) after CPB. Phosphorylated IκB-α/total IκB-α ratio was assessed before and after CPB in right atrial biopsies. Results: Baseline and operative data did not differ between groups. Statin therapy was associated with lower preoperative low-density lipoprotein levels compared to control (73 ± 6 vs. 92 ± 6 mg/dL; p = 0.03). Release of IL-6 was attenuated in the statin group at 4 h (2270 ± 599 vs. 5120 ± 656 pg/ml; p < 0.01) and 10 h (1295 ± 445 vs. 3116 ± 487 pg/ml; p < 0.05) compared to the control group. IL-10 increased after surgery in both groups (p < 0.05), but was higher in the statin group at 1 h (66 ± 15 vs. 26 ± 16 pg/mL; p < 0.01). Phosphorylated IκB-α/total IκB-α ratio before CPB did not differ between groups, but was elevated after CPB in both groups (p < 0.05), indicating enhanced degradation of IκB-α. Statin therapy had no effect on TNFα and IL-8. Conclusions: Preoperative statin therapy attenuates the release of pro-inflammatory IL-6 and up-regulates anti-inflammatory IL-10 after cardiac surgery with cardioplegia, but fails to inhibit phosphorylation of myocardial IκB-α.

Key words

Statins - inflammatory response - cytokines - cardiovascular surgery

References

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