Beta-blockers and statins are individually associated with reduced mortality in patients undergoing noncardiac, nonvascular surgery

Noordzij, Peter G.; Poldermans, Don; Schouten, Olaf; Schreiner, Frodo; Feringa, Harm H.H.; Dunkelgrün, Martin; Kertai, Miklós D.; Boersma, Eric

doi:10.1097/mca.0b013e328010a461

Cited by 32 publications

(13 citation statements)

References 18 publications

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“…This reduction in mortality was consistent in subgroup analysis independent of the type of surgery, cardiac risk factors, and cardiovascular therapy, including aspirin and β-blockers (Poldermans et al 2003). Similar conclusions were reached by Noordzij and colleagues (2007) in a case-controlled study in 75,581 patients who underwent 108,593 noncardiac, nonvascular surgical procedures over a 10 year period between 1991 and 2001, statins were associated with a 60% mortality reduction.…”

Section: Perioperative Use Of Statinssupporting

confidence: 69%

Perioperative use of statins in noncardiac surgery

Chan

Cheng²,

Irwin³

2008

Vasc Health Risk Manag

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Section: Perioperative Use Of Statinssupporting

confidence: 69%

Perioperative use of statins in noncardiac surgery

Chan

Cheng²,

Irwin³

2008

Vasc Health Risk Manag

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“…Small randomized trials suggested statins decrease perioperative cardiac events, 22,23 and in observational studies, statin use was associated with less perioperative mortality. [27][28][29][30][31][32] As well, in some observational studies, statin use was associated with fewer renal events (sample sizes of 77 to 2760 patients; renal outcomes were a change in serum creatinine or estimated GFR and acute dialysis). 16,17,19 It is biologically plausible that statins decrease renal injury, and a protective effect of statins on the kidney has been shown in several animal studies.…”

Section: Discussionmentioning

confidence: 99%

Statin Use Associates with a Lower Incidence of Acute Kidney Injury after Major Elective Surgery

Molnar

Coca

Devereaux

et al. 2011

Journal of the American Society of Nephrology

107

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Statins abrogate ischemic renal injury in animal studies but whether they are renoprotective in humans is unknown. We conducted a population-based retrospective cohort study that included 213,347 older patients who underwent major elective surgery in the province of Ontario, Canada from 1995 to 2008. During the first 14 postoperative days, 1.9% (4020 patients), developed acute kidney injury and 0.5% (1173 patients), required acute dialysis. The 30-day mortality rate was 2.8% (5974 patients). Prior to surgery, 32% of patients were taking a statin. After statistical adjustment for patient and surgical characteristics, statin use associated with 16% lower odds of acute kidney injury (OR, 0.84; 95% CI, 0.79 to 0.90), 17% lower odds of acute dialysis (OR, 0.83; 95% CI, 0.72 to 0.95), and 21% lower odds of mortality (OR, 0.79; 95% CI, 0.74 to 0.85). Propensity score matching produced similar results. These data suggest that statins may protect against renal complications after major elective surgery and reduce perioperative mortality.

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“…Considering the rebound effect with statin interruption, this effort to temporally account for statin administration is more rigorous than the recent study by Noordzij et al 54 These authors find a 60% reduction in mortality within 30 days of surgery with statin use ͓adjusted OR 0.40, 95% CI 0.24 -0.68͔. Perioperative statin use is the inclusion criteria for the statin group but no other details are given regarding timing of therapy in their study of 2868 noncardiac nonvascular surgery patients.…”

Section: Observational Studiesmentioning

confidence: 98%