Comparative Effects of Different Statin Regimens on Postoperative Outcomes in Isolated Coronary Artery Bypass Grafting: A Propensity Score-Matched Analysis

Background: This study aimed to evaluate the impact of various preoperative statin types and dosage regimens on early postoperative outcomes following isolated coronary artery bypass grafting (CABG). Methods: A total of 950 patients who underwent isolated CABG between 2022 and 2026 were evaluated and stratified into three groups based on their preoperative statin status: Group A, statin-naive patients (n = 592); Group B, atorvastatin users (n = 293); and Group C, rosuvastatin users (n = 65). To analyze the dose-dependent outcomes of statins, patients in Group B were subsequently segregated into two subgroups and matched using propensity score matching: Group 3, low-to-moderate regimen (≤20 mg/day; n = 75), and Group 4, high-dose regimen (>20 mg/day; n = 75). Results: Except for the higher incidence of diabetes mellitus and hypertension in statin-treated patients, all pre- and intraoperative characteristics of Groups A, B, and C were similar, and all of their postoperative outcomes except new-onset atrial fibrillation (NOAF) were similar. NOAF incidence was significantly higher in statin-naive patients compared to both the atorvastatin and rosuvastatin cohorts [109 (18.4%) - 35 (11.9%) - 7 (10.8%), p = 0.02]. All early postoperative outcomes—including in-hospital mortality and NOAF incidence—were found to be fully similar between Groups 3 and 4. Furthermore, multivariable analysis confirmed preoperative statin use as an independent protective factor against NOAF. Conclusions: The preoperative utilization of either atorvastatin or rosuvastatin was associated with a lower NOAF incidence in isolated CABG, and no significant differences were observed between the atorvastatin and rosuvastatin cohorts regarding NOAF and other postoperative outcomes. Preoperative atorvastatin administration at doses below and above 20 mg/day showed no significant differences in terms of postoperative outcomes.