Effective of pre-operative high dose Atorvastatin on the levels of myocardial injury marker (Troponin-I) early after conventional CABG

Introduction: Coronary artery bypass grafting (CABG) is commonly associated with perioperative myocardial injury, reflected by elevated cardiac troponin-I (cTn-I) levels. Atorvastatin possesses anti-inflammatory and antioxidant properties that may reduce myocardial damage following CABG. Objectives: To evaluate the effect of preoperative high-dose atorvastatin therapy on myocardial injury in patients undergoing conventional on-pump CABG and to compare postoperative troponin-I levels between high-dose and low-dose atorvastatin groups. Materials and Methods: This prospective observational study was conducted at the National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh, from January 2011 to December 2012 among 60 patients undergoing conventional CABG. Patients were divided into two groups: Group I (n=30) received atorvastatin 80 mg/day for 2 days preoperatively, while Group II (n=30) received atorvastatin 10 mg/day. Demographic variables, risk factors, cardiopulmonary bypass time, aortic cross-clamp time, and serum troponin-I levels were compared. Troponin-I was measured preoperatively and 24 hours postoperatively. Data were analyzed using SPSS. Results: Baseline demographic characteristics, cardiovascular risk factors, left ventricular ejection fraction, cardiopulmonary bypass time, and aortic cross-clamp time were comparable between the groups (p>0.05). Preoperative troponin-I levels showed no significant difference. However, postoperative 24-hour troponin-I levels were significantly lower in Group I compared with Group II (1.79±0.23 ng/ml vs 2.72±0.24 ng/ml; p<0.0001). Discussion and Conclusion: Preoperative high-dose atorvastatin significantly reduced postoperative myocardial injury marker levels following conventional CABG. High-dose atorvastatin therapy appears safe and may provide myocardial protection in patients undergoing on-pump CABG. Medicine Today 2026, Vol.38 (2): 228-231