对将接受心脏手术患者进行他汀预处理可预防患者术后心房颤动(简称房颤)。但上述结论是基于观察性和有限的随机试验证据，他汀类药物的这一益处在临床实际应用中如何?多国学者对此进行了联合荟萃分析，结果表明，短期他汀预处理可能减少心脏手术患者术后房颤风险。相关论文近期发表于Europace杂志。

        研究者们详细检索了MEDLINE和PubMed数据库，审阅了已发表研究的参考文献列表并联系参与试验者，以获取荟萃分析中的个体参与者数据。证据组合来源于前瞻性随机临床研究，这些研究均对比了在择期心脏手术之前，接受他汀预处理或安慰剂/对照药物治疗的患者术后房颤风险。以房颤持续发作时间≥5分钟定义为术后房颤。

        结果显示，共纳入了11项试验中的1105例受试者，其中，552例接受了术前他汀治疗。接受和未接受他汀预处理患者的术后房颤发生率分别为19%和36%(比值比0.41，P < 0.00001)。他汀预处理预防房颤的作用在不同亚组人群中也一致。

        参考文献：Patti G, et al. Europace.2015 Mar 1. pii: euv001. [Epub ahead of print]

Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials.
Patti G1, Bennett R2, Seshasai SR2, Cannon CP3, Cavallari I1, Chello M1, Nusca A1, Mega S1, Caorsi C4, Spadaccio C5, Keun On Y6, Mannacio V7, Berkan O8, Yilmaz MB9, Katrancioglu N9, Ji Q10, Kourliouros A11, Baran Ç12, Pasceri V13, Rüçhan Akar A12, Carlos Kaski J2, Di Sciascio G1, Ray KK14.

Abstract
AIMS:
Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF). However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine anti-arrhythmic benefits of these agents in this setting. We therefore aimed to quantify precisely the association between statin pretreatment and postoperative AF among patients undergoing cardiac surgery.
METHODS AND RESULTS:
A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012) was conducted, followed by a review of the reference lists of published studies and correspondence with trial investigators to obtain individual-participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting ≥5 min.
Overall, 1105 participants from 11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval 0.31-0.54, P < 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatment was consistent across different subgroups.
CONCLUSION:
Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery.