Improved postoperative outcomes associated with preoperative statin therapy.
Statin therapy is well established for prevention of cardiovascular disease. Statins may also reduce postoperative mortality and morbidity via a pleiotropic (non-lipid-lowering) effect. The authors conducted a meta-analysis to determine the influence of statin treatment on adverse postoperative outcomes in patients undergoing cardiac, vascular, or noncardiovascular surgery. Two independent authors abstracted data from 12 retrospective and 3 prospective trials (n = 223,010 patients). A meta-analysis was performed to evaluate the overall effect of preoperative statin therapy on postoperative outcomes. Preoperative statin therapy was associated with 38% and 59% reduction in the risk of mortality after cardiac (1.9% vs. 3.1%; P = 0.0001) and vascular (1.7% vs. 6.1%; P = 0.0001) surgery, respectively. When including noncardiac surgery, a 44% reduction in mortality (2.2% vs. 3.2%; P = 0.0001) was observed. Preoperative statin therapy may reduce postoperative mortality in patients undergoing surgical procedures. However, the statin associated effects on postoperative cardiovascular morbidity are too variable to draw any conclusion.
Hindler
Katja
K
Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston, Texas, USA.
Shaw
Andrew D
AD
Samuels
Joshua
J
Fulton
Stephanie
S
Collard
Charles D
CD
Riedel
Bernhard
B
D000818:Animals; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002316:Cardiotonic Agents; D003627:Data Interpretation, Statistical; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects
D002316:Cardiotonic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors