Changing the Practice of Perioperative Cardioprotection

Auerbach, Andrew D.

doi:10.1161/circoutcomes.108.795377

Cited by 11 publications

(5 citation statements)

References 24 publications

(25 reference statements)

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“…The role of beta-blockers has been rapidly evolving, with recent literature suggesting no net clinical benefit (and perhaps harm) associated with the routine peri-operative administration of beta-blockers for non-cardiac surgery. 21,22 Meanwhile, peri-operative statin use has garnered increasing interest as a preventive strategy. A large study by Lindenauer et al suggested that statin use is associated with lower mortality in a population of patients undergoing major non-cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Statin Use And Postoperative Atrial Fibrillation After Major Noncardiac Surgery

et al. 2012

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Background Although statin lipid-lowering medications likely reduce peri-operative ischemic complications, few data exist to describe statins’ effects on risk for and outcomes of atrial fibrillation following non-cardiac surgery. Objective To examine the association between treatment with statin medications and clinically significant post-operative atrial fibrillation (POAF) following major non-cardiac surgery. Methods A retrospective cohort study of patients aged 18 years or older who underwent major non-cardiac surgery between January 1, 2008 and December 31, 2008. Cases of clinically significant POAF were selected using a combination of ICD-9 codes and clinical variables. We defined statin users as those whose pharmacy data included a charge for a statin drug on the day of surgery, the day after surgery, or both. Results Of 370447 patients, 10957 (3.0%) developed clinically significant POAF; overall, 79871 (21.6%) received a peri-operative statin. Patients receiving statins were generally older (68.8 vs. 61.1 years; P<0.001) and more likely to be receiving a beta-blocker (50.3% vs. 21.6%; P<0.001). Statin use was associated with a lower unadjusted rate of POAF (2.6% vs. 3.0%; P<0.001). After adjustment for patient risk factors and surgery type, odds for POAF remained significantly lower among statin-treated patients (adjusted odds ratio [AOR] 0.79; 95% confidence interval [CI] 0.71–0.87; P<0.001). Statin use was not associated with differences in cost, length of stay, or mortality among patients who developed POAF. Conclusion Treatment with statin agents appears to be associated with lower risk of clinically significant POAF following major non-cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Statin Use And Postoperative Atrial Fibrillation After Major Noncardiac Surgery

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Statin use and postoperative atrial fibrillation after major noncardiac surgery

Bhave

Auerbach

2012

Heart Rhythm

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“…10 Finally, 2 commentaries will interpret the practical implications of recent, high-visibility trials (Simvastatin and Ezetimibe in Aortic Stenosis [SEAS] and PeriOperative ISchemic Evaluation [POISE]), providing some guidance for clinical practice and policy. 11,12 How can you contribute to the journal's success? We are open to your ideas about how to continually improve; our ultimate success will depend on the goodwill, enthusiasm, and involvement of our community and the sense that this initiative will only succeed through our joint efforts.…”

Section: Scientific Forum On Quality Of Care and Outcomes Researchmentioning

confidence: 99%

Circulation: Cardiovascular Quality and Outcomes

Krumholz

2008

Circ: Cardiovascular Quality and Outcomes

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T he launch of Circulation: Cardiovascular Quality and Outcomes occurs during a time in which the healthcare system is simultaneously achieving its greatest triumphs and facing its most daunting challenges. As a profession, we are manifesting remarkable advances in our ability to understand, prevent, and treat cardiovascular disease and stroke, yet there are vast gaps in our ability to preempt, mitigate, and cure these conditions. Often, these gaps derive from a lack of evidence about how best to provide care and public health interventions, how best to prioritize resources, and how best to work collaboratively with and in the best interests of the public and our patients.Scholarship is needed to promote improvements in cardiovascular and stroke health and health care, focusing on the end results of our efforts. Outcomes research provides evidence to support efforts to achieve safe, effective, efficient, equitable, timely, and patient-centered care. 1 We envision the journal as a venue for content of consequence-a home for outstanding science, commentary, and novel ideas. The journal will be a catalyst for good science with practical implications and a means to inspire junior people to engage in scholarly activities that have practical applicability.The mission of Circulation: Cardiovascular Quality and Outcomes is to improve clinical decision making, population health, and healthcare policy. Moreover, Circulation: Cardiovascular Quality and Outcomes aspires to play a leading role in strengthening the global community dedicated to eliminating the epidemic of cardiovascular disease and stroke. This will be accomplished through a format that promotes scholarship, education, and constructive debate. The audience for this journal includes researchers, clinicians, policymakers, administrators, health plan executives, and government agency professionals.The journal's name is noteworthy. As part of the Circulation family, it occupies a place within a strong tradition of excellence and an association with the American Heart Association (AHA) and with the American Stroke Association. The term Quality and Outcomes is intended to convey our interest in how care and preventive strategies are delivered and what is achieved for patients and the public. The journal will be a home for contributions that span epidemiology, clinical epidemiology, management sciences, economics, statistics, health policy, quality improvement, and other fields. The publications will have a common link to practical importance, with the possibility of informing practice and policy.For the cardiovascular and stroke community, this journal completes the quartet of initiatives at the AHA to support the growth and development of outcomes research and to elevate the quality of cardiovascular care. In 1999, the Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke was launched. Several years later, the AHA formed the Interdisciplinary Working Group on Quality of Care and Outcomes Research to allow a governing struct...

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Changing the Practice of Perioperative Cardioprotection

Cited by 11 publications

References 24 publications

Statin Use And Postoperative Atrial Fibrillation After Major Noncardiac Surgery

Statin Use And Postoperative Atrial Fibrillation After Major Noncardiac Surgery

Statin use and postoperative atrial fibrillation after major noncardiac surgery

Circulation: Cardiovascular Quality and Outcomes

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