Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.
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.
Mathew
Joseph P
JP
Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. mathe014@mc.duke.edu
Grocott
Hilary P
HP
McCurdy
James R
JR
Ti
Lian K
LK
Davis
R Duane
RD
Laskowitz
Daniel T
DT
Podgoreanu
Mihai V
MV
Swaminathan
Madhav
M
Lynch
John
J
Stafford-Smith
Mark
M
White
William D
WD
Newman
Mark F
MF
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
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