Statin Therapy in Ischaemia Reperfusion in Coronary Artery Bypass Grafting STIR

After prolonged ischaemia, there are reversibly damaged but viable cells that are further injured when blood flow is quickly restored to the heart. This phenomenon is called ischaemia-reperfusion injury (IRI). Evidence is mounting for statins, a family of drugs normally used to lower cholesterol, in terms of anti-inflammation, antioxidant and relaxation and improved function of blood vessels, which is cholesterol independent. There has been preliminary data suggesting that statins may be beneficial in patients undergoing coronary artery stenting placement by decreasing the amount of damage secondary to IRI. The beneficial effects appear to wane with long term statin use but can be 'recaptured' with a reload of statins prior to the stenting procedure. The same effect in heart surgery patients is unclear.

The aim of our study is to show whether giving Rosuvastatin before surgery may be of benefit in patients undergoing bypass surgery. On-pump coronary artery bypass grafting submits a patient’s heart to considerable operative stress including IRI even at the hands of a careful surgeon. We will establish if Rosuvastatin reload ameliorate IRI, as detected by sensitive cardiac biomarkers and Cardiac Magnetic Resonance Imaging, in patients undergoing coronary artery bypass grafting. This study will help us understand whether statins, which are cheap and readily available, possess further attributes that would be desirable in further looking after patients' hearts during surgery.