Preoperative statin is associated with decreased operative mortality in high risk coronary artery bypass patients

Abstract

BackgroundStatins are widely prescribed to patients with atherosclerosis. A retrospective database analysis was used to examine the role of preoperative statin use in hospital mortality, for patients undergoing isolated coronary artery bypass grafting (CABG.)MethodsThe study population comprised 2377 patients who had isolated CABG at Allegheny General Hospital between 2000 and 2004. Mean age of the patients was 65 ± 11 years (range 27 to 92 years). 1594 (67%) were male, 5% had previous open heart procedures, and 4% had emergency surgery. 1004 patients (42%) were being treated with a statin at the time of admission. Univariate, bivariate (Chi2, Fisher's Exact and Student's t-tests) and multivariate (stepwise linear regression) analyses were used to evaluate the association of statin use with mortality following CABG.ResultsAnnual prevalence of preoperative statin use was similar over the study period and averaged 40%. Preoperative clinical risk assessment demonstrated a 2% risk of mortality in both the statin and non-statin groups. Operative mortality was 2.4% for all patients, 1.7% for statin users and 2.8% for non-statin users (p < 0.07). Using multivariate analysis, lack of statin use was found to be an independent predictor of mortality in high-risk patients (n = 245, 12.9% vs. 5.6%, p < 0.05).ConclusionsBetween 2000 and 2004 less than 50% of patients at this institution were receiving statins before admission for isolated CABG. A retrospective analysis of this cohort provides evidence that preoperative statin use is associated with lower operative mortality in high-risk patients.

Preoperative statins improve recovery of renal function but not by an anti-inflammatory effect: observational study in 69 elderly patients undergoing cardiac surgery

“…Both high-dose and low-dose statin therapy were not associated with a significant reduction in the incidence of postoperative AKI [16]. Moreover, our statin group had a significantly shorter mean postoperative stay, but similar ICU stay and survival, in contrast with the findings of previous reports [17]. It could be speculated that statin may accelerate the recovery of renal function after the hypoperfusion injury that follows CPB, without any impact on major postoperative outcomes.…”

Perioperative Statin Therapy for Patients Undergoing Coronary Artery Bypass Grafting

“…In the following years, Huffmyer and associates [41] retrospectively analyzed 2,760 patients who underwent CABG at a single institution during a 10-year period, and showed a significant 43% reduction in in-hospital mortality with PST (OR, 0.57; 95% CI, 0.42 to 0.78; p < 0.001). Another retrospective, single-center study by Magovern and colleagues [42], which included 2,377 patients undergoing isolated CABG during a 5-year period, demonstrated that PST was an independent predictor of in-hospital mortality (stepwise logistic regression coefficient, À1.07; p ¼ 0.03), particularly in high-risk patients, in whom the predicted mortality was 6% or greater. Similar association was shown by Oddsson and coworkers [43], in which PST significantly reduced the odds of operative mortality (OR, 0.33; 95% CI, 0.11 to 0.88; p ¼ 0.046).…”

Relevancy of High Dose Statins Application Before and After Myocardium Revascularization

“…В исследовании с участием 2 377 больных операционная летальность в группе приема статинов составила 1,7%, а у больных, не принимавших статины, 2,8% (р < 0,07). При множественном регрессионном анализе отсутствие ста-тинов в терапии служило независимым предиктором смертельных исходов (n = 245; 12,9 против 5,6% при при-еме статинов; р < 0,05) [16].…”