title: Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.
abstract: OBJECTIVE
  The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory response.
  
  
  METHODS
  Retrospective observational study of patients undergoing coronary artery bypass grafting surgery.
  
  
  METHODS
  Referral center for cardiothoracic surgery at a university hospital.
  
  
  METHODS
  Four hundred forty patients undergoing coronary artery bypass grafting surgery with cardiopulmonary bypass.
  
  
  METHODS
  None.
  
  
  RESULTS
  Thirty-five percent of patients received statins in the preoperative period. Multivariable analysis revealed no effect of preoperative statin therapy on cognitive function (p = 0.67). Post hoc analysis revealed that statin therapy at hospital discharge was associated with less improvement in cognitive performance at 6 weeks after surgery (p = 0.011). No significant differences were found between statin therapy groups in either range or maximum value of any of the cytokines (p > 0.05).
  
  
  CONCLUSIONS
  Preoperative statin therapy did not decrease the inflammatory response to cardiopulmonary bypass or the cognitive dysfunction commonly seen after cardiac surgery.
authors.affiliation: Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. mathe014@mc.duke.edu
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Mathew
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Grocott
authors.forename: James R
authors.initials: JR
authors.lastname: McCurdy
authors.forename: Lian K
authors.initials: LK
authors.lastname: Ti
authors.forename: R Duane
authors.initials: RD
authors.lastname: Davis
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Laskowitz
authors.forename: Mihai V
authors.initials: MV
authors.lastname: Podgoreanu
authors.forename: Madhav
authors.initials: M
authors.lastname: Swaminathan
authors.forename: John
authors.initials: J
authors.lastname: Lynch
authors.forename: Mark
authors.initials: M
authors.lastname: Stafford-Smith
authors.forename: William D
authors.initials: WD
authors.lastname: White
authors.forename: Mark F
authors.initials: MF
authors.lastname: Newman
mesh_terms: D002097:C-Reactive Protein / Q000187:drug effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy; D053645:Interleukin-2 Receptor alpha Subunit; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D018123:Receptors, Interleukin / Q000097:blood / Q000187:drug effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000187:drug effects
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C508017:IL2RA protein, human; D053645:Interleukin-2 Receptor alpha Subunit; D015850:Interleukin-6; D018123:Receptors, Interleukin; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein