Statin therapy is associated with reduced total and cardiovascular mortality after coronary artery bypass grafting surgery.
OBJECTIVE
In an observational study, we evaluated the association between postoperative statin therapy and long-term mortality among patients undergoing a first-ever coronary artery bypass grafting (CABG) surgery.


METHODS
In an outpatient clinic setting, we assessed 1869 consecutive patients (age 58.7+/-9.6 years; 1657 men), who survived the 1st month after a first-ever CABG, within a 17-year period. Cox proportional hazard analysis was used to calculate the adjusted hazard ratios (adjusting for age, smoking, the presence of hypertension, diabetes mellitus, lipid profile at the time of the procedure, vessel disease, number and kind of grafts used, and concomitant treatment) for patients receiving statin treatment during follow-up and adjusted Kaplan-Meier survival curves were constructed.


RESULTS
During a 9345 patient-years follow-up, 48% of the patients were on a statin. In a total of 222 deaths, 80.6% were because of cardiovascular causes. Total and cardiovascular mortality were significantly reduced in patients receiving statin therapy [adjusted hazard ratio, 0.48 (95% confidence interval, 0.28-0.82); P=0.007), and 0.43 (95% confidence interval, 0.23-0.80); P=0.007, respectively]. The estimated 16-year Kaplan-Meier survival curves diverged at 2 years and thereafter.


CONCLUSIONS
Taking into account the potential limitations of observational data, statin treatment postoperatively is associated with a 50% reduction in total and cardiovascular mortality in patients undergoing a first-ever CABG.
Papathanasiou
Athanasios
A
Department of Cardiology, School of Medicine, University of Ioannina, Ioannina, Greece.
Toumpoulis
Ioannis K
IK
Milionis
Haralampos J
HJ
Kalantzi
Kallirroi
K
Katsouras
Christos S
CS
Goudevenos
John
J
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors