Perioperative Statins to Prevent AFib After Lung Surgery

Inclusion criteria

• Age 60 years or older.
• Scheduled to undergo isolated anatomical lung resection, including pulmonary segmentectomy or lobectomy.
• Sinus rhythm documented by a preoperative electrocardiogram.
• Not receiving antiarrhythmic medication, with the exception of beta-blockers.
• Willing and able to provide written informed consent.

Exclusion criteria

• Untreated hyperthyroidism or hypothyroidism.
• History of obstructive hepatobiliary disease, active liver disease, or other serious liver disease.
• Preoperative serum creatinine greater than 150 μmol/L.
• Known allergy to atorvastatin or another statin, or a history of a serious statin-related adverse reaction, including statin-associated myopathy.
• Personal or family history of an inherited muscle disorder.
• Continuous use within 1 month before randomization of fibrates, niacin, or medications that strongly inhibit cytochrome P450 or P-glycoprotein, including cyclosporine, oral azole antifungal agents, certain interacting antibiotics, protease inhibitors, nefazodone, or amiodarone.
• Consumption of 1 liter or more of grapefruit juice per day within 1 month before randomization.
• Current treatment with a high-intensity statin regimen, including atorvastatin 40 mg/day or higher or rosuvastatin 20 mg/day or higher.
• Any other condition that, in the investigator's judgment, would make participation unsafe or interfere with the conduct or evaluation of the study.