Incidence of perioperative myocardial infarction and of 2-year mortality in 577 elderly patients undergoing noncardiac vascular surgery treated with and without statins.
Of 577 patients, mean age 74 years, undergoing noncardiac vascular surgery, 300 (52%) had carotid endarterectomy, 179 (31%) had lower extremity revascularization, and 98 (17%) had abdominal aortic aneurysm repair. Of the 577 patients, 302 (52%) were treated with statins. Perioperative myocardial infarction (MI) occurred in 18 of 302 patients (6%) treated with statins and in 38 of 275 patients (14%) not treated with statins (p=0.001). Two-year mortality occurred in 18 of 302 patients (6%) treated with statins and in 43 of 275 patients (16%) not treated with statins (p=0.0002). Perioperative MI or mortality occurred in 34 of 302 patients (11%) treated with statins and in 74 of 275 patients (27%) not treated with statins (p<0.0001). Stepwise Cox regression analysis showed that significant independent prognostic factors for perioperative MI or death were use of statins (risk ratio=RR=0.43, p<0.0001), use of beta blockers (RR=0.55, p=0.002), carotid endarterectomy (RR=0.60, p=0.009), and diabetes (RR=1.5, p=0.045). In conclusion, patients undergoing noncardiac vascular surgery treated with statins had a 57% less chance of having perioperative MI or death at 2-year follow-up after controlling for other variables.
Desai
Harit
H
Cardiology Division, Department of Medicine, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY 10595, USA.
Aronow
Wilbert S
WS
Ahn
Chul
C
Gandhi
Kaushang
K
Amin
Harshad
H
Lai
Hoang M
HM
Tsai
Fausan S
FS
Sharma
Mala
M
Babu
Sateesh
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D016894:Endarterectomy, Carotid / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000517:prevention & control; D019990:Perioperative Care / Q000401:mortality*; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000401:mortality*
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors