Effect of Statins on Development of Early Cognitive Dysfunction After Coronary Artery Bypass Grafting

Associations of dyslipidaemia and lipid-lowering treatment with risk of postoperative cognitive dysfunction: a systematic review and meta-analysis

“…One Russian study compared the effects of preoperative rosuvastatin treatment for 10 to 14 days before surgery and until hospital discharge versus not receiving that treatment. The sample consisted of 109 middle-aged to older males undergoing CABG, and at 7-day to 10-day follow-up, the group receiving rosuvastatin outperformed the control group on tests of memory, attention and processing speed 43. The finding is contrasted with a recent UK randomised controlled trial.…”

“…Here, either simvastatin or placebo was administered to 142 patients and no effect of intervention on risk of POCD 6 months after surgery was found 44. However, that study was of critically ill patients, and so is not necessarily representative of the general older population undergoing surgery, had high loss to cognitive follow-up (66.2%) and, unlike the Russian trial,43 initiated statin treatment immediately after surgery 44. Effects of longer-term preoperative statin use on POCD risk were not addressed.…”

“…In that study of 229 patients undergoing cardiac surgery, 126 (55.0%) had developed POCD by 1-year follow-up and statin use at discharge was unrelated to POCD risk (RR 1.10; 95% CI 0.87 to 1.38; P=0.441) 42. Two trials were excluded from our analysis due to non-English language43 or initiation of statin treatment after surgery 44. One Russian study compared the effects of preoperative rosuvastatin treatment for 10 to 14 days before surgery and until hospital discharge versus not receiving that treatment.…”

“…Importantly, we had no information on duration of statin treatment for any of the included studies; patients’ statin use over the course of decades prior to surgery is thus unknown. Given that the trial that had initiated statins after surgery found no effect on POCD risk44 whereas the Russian study that had used statins for 10 to 14 days before surgery reported beneficial effects43 implies a central role of treatment duration in risk modification, which warrants clarification in future randomised controlled trials (RCTs).…”

Diabetes Patient and Myocardial Revascularization From the Evidence Guided Perspective: Cardiologist Opinion. Part 2

“…По данным этого же иссле-дования, факт приема ингибиторов ангиотензин-превращающего фермента (АПФ), бета-блокато-ров, антагонистов кальция не показали значимой связи с исходами КШ [41]. Имеются данные о бла-гоприятном влиянии статинов на снижение частоты фибрилляции предсердий и когнитивных наруше-ний после КШ, в том числе, у пациентов с сахар-ным диабетом [41,42].…”