Statins decrease adverse outcomes in coronary artery bypass for extensive coronary artery disease as well as left main coronary stenosis.
The aim of this study was to evaluate the effects of preoperative and postoperative statins on coronary artery bypass grafting (CABG) for extensive coronary artery disease as well as left main coronary stenosis (LMS). The data of 626 cases of extensive coronary artery disease as well as LMS patients in Anzhen Hospital between January 1998 and March 2008 for CABG procedure were retrospectively analyzed, and were classified as preoperative statin therapy group (Group A, n = 320) or preoperative no statin therapy group (Group B, n = 306). Propensity scores were estimated to determine the probability of inclusion into statin therapy group, resulting in the successful matching of 267 pairs. The incidence of in-hospital death, and atrial fibrillation or flutter and disabling stroke was higher in Group B than in Group A. The actuarial freedom from late events at 5 yrs were 98.75%+/- 0.73% for the postoperative statin therapy group and 88.33%+/- 3.71% for the postoperative no statin therapy group respectively, P= 0.000. The logistic regression revealed that CRP (>5.0 mg/L), and elevated Troponin I, and emergent procedure, and preoperative IABP support, and EF < 40% were the independent risk factors, and preoperatively statins was the protective factor for the perioperative death; and the Cox proportional hazard also revealed that preoperative IABP support and preoperative cardiac arrest, and EF < 40% were independent risk factors, and postoperatively statins were the protective factor for the late cardiac events. Preoperative statin therapy could provide protective effect in the perioperative period. Postoperative statin usage could provide protective effect on the late cardiac events.
Gan
Hui-Li
HL
Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing 100029, China. ganhuili@hotmail.com
Zhang
Jian-Qun
JQ
Bo
Ping
P
Wang
Sheng-Xun
SX
Lu
Chun-Shang
CS
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control; D001282:Atrial Flutter / Q000209:etiology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016009:Chi-Square Distribution; D002681:China; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D023921:Coronary Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019990:Perioperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors