title: [New aspects of perioperative statin therapy].
abstract: Statins are effective drugs for treatment and prevention of cardiovascular diseases. Besides their lipid-lowering properties, statins act through multiple pleiotropic effects including vasoprotective mechanisms, effects on coagulation, anti-inflammatory properties and stabilization of atherosclerotic plaques. In recent years many studies have investigated the effects of statins administered to patients in the perioperative period. Results indicate that the perioperative use of statins is beneficial, most of all for patients with a high cardiovascular risk profile. However, most study designs are retrospective and vulnerable to systematic bias. The number of randomized controlled trials is very limited and include only low numbers of patients. Currently it is not known when perioperative treatment with statin should be started and how long it should be continued postoperatively to reach optimal protective effects. A pre-existing statin therapy should be continued perioperatively because discontinuation leads to a higher rate of complications in the perioperative period. Larger randomized controlled trials are therefore necessary to evaluate the efficiency and the safety of perioperative statin use, especially for patients with a low or intermediate cardiovascular risk profile.
authors.affiliation: Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, 50937 Köln, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Butte
authors.forename: B W
authors.initials: BW
authors.lastname: Böttiger
authors.forename: O
authors.initials: O
authors.lastname: Liakopoulos
authors.forename: P
authors.initials: P
authors.lastname: Teschendorf
mesh_terms: D000075202:Contraindications; D004347:Drug Interactions; D017408:Guidelines as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019990:Perioperative Care; D012189:Retrospective Studies; D040242:Risk Reduction Behavior
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
references.citation: JAMA. 2004 May 5;291(17):2092-9
references.pmid: 15126437
references.citation: J Am Coll Cardiol. 2009 Aug 4;54(6):566-8
references.pmid: 19643321
references.citation: Anaesthesist. 2008 Dec;57(12):1183-92
references.pmid: 18704341
references.citation: Anaesthesist. 2002 Jan;51(1):2-15
references.pmid: 11963295
references.citation: Circulation. 2005 May 10;111(18):2356-63
references.pmid: 15867181
references.citation: J Am Coll Cardiol. 2009 Aug 4;54(6):558-65
references.pmid: 19643320
references.citation: Cardiol Rev. 2008 Jul-Aug;16(4):205-12
references.pmid: 18562811
references.citation: Eur J Anaesthesiol. 2003 Aug;20(8):662-7
references.pmid: 12932070
references.citation: Stroke. 2005 Oct;36(10):2072-6
references.pmid: 16179564
references.citation: Am J Cardiol. 2007 Jul 15;100(2):316-20
references.pmid: 17631090
references.citation: Am J Cardiol. 2005 Mar 1;95(5):658-60
references.pmid: 15721114
references.citation: J Am Coll Cardiol. 2004 Aug 4;44(3):720-32
references.pmid: 15358046
references.citation: Anesth Analg. 2009 Aug;109(2):572-84
references.pmid: 19608834
references.citation: Ann Surg. 2009 Jun;249(6):921-6
references.pmid: 19474688
references.citation: Am J Cardiol. 2006 Apr 17;97(8A):6C-26C
references.pmid: 16581330
references.citation: Clin Pharmacokinet. 2008;47(7):463-74
references.pmid: 18563955
references.citation: Am J Cardiol. 1995 Jul 13;76(2):122A-125A
references.pmid: 7604786
references.citation: N Engl J Med. 2008 Nov 20;359(21):2195-207
references.pmid: 18997196
references.citation: Anaesthesist. 2007 Mar;56(3):285-96; quiz 297-8
references.pmid: 17342546
references.citation: Br J Anaesth. 2008 Mar;100(3):288-98
references.pmid: 18276651
references.citation: Consult Pharm. 2009 May;24(5):372-9
references.pmid: 19555146
references.citation: Circulation. 1999 Sep 7;100(10):1043-9
references.pmid: 10477528
references.citation: JAMA. 2001 Jul 4;286(1):64-70
references.pmid: 11434828
references.citation: Lancet. 2009 Apr 4;373(9670):1175-82
references.pmid: 19329177
references.citation: Circulation. 2006 Dec 19;114(25):2788-97
references.pmid: 17159064
references.citation: N Engl J Med. 2006 Aug 10;355(6):549-59
references.pmid: 16899775
references.citation: Am J Cardiol. 1998 Mar 1;81(5):582-7
references.pmid: 9514454
references.citation: J Clin Pharmacol. 2009 May;49(5):568-73
references.pmid: 19398603
references.citation: Eur Heart J. 2009 Nov;30(22):2769-812
references.pmid: 19713421
references.citation: Anesth Analg. 2007 Jun;104(6):1326-33, table of contents
references.pmid: 17513620
references.citation: J Vasc Surg. 2004 May;39(5):967-75; discussion 975-6
references.pmid: 15111846
references.citation: Ir J Med Sci. 2000 Jul-Sep;169(3):176-9
references.pmid: 11272871
references.citation: Eur Heart J. 2007 Oct;28(19):2375-414
references.pmid: 17726041
references.citation: Anesthesiology. 2009 Jul;111(1):205; author reply 205-6
references.pmid: 19546699
references.citation: Lancet. 2002 Jul 6;360(9326):7-22
references.pmid: 12114036
references.citation: Endothelium. 2003;10(1):35-41
references.pmid: 12699075
references.citation: J Cardiovasc Pharmacol. 2009 Feb;53(2):137-44
references.pmid: 19188835
references.citation: Eur Heart J. 2008 Jun;29(12):1548-59
references.pmid: 18506053
references.citation: Circulation. 1998 Apr 21;97(15):1440-5
references.pmid: 9576423
references.citation: Anesthesiology. 2006 Dec;105(6):1260-72; quiz 1289-90
references.pmid: 17122590
references.citation: J Am Coll Cardiol. 2007 Oct 23;50(17):1649-56
references.pmid: 17950146
references.citation: Anaesthesist. 2003 Sep;52(9):839-59
references.pmid: 14575048
references.citation: Br J Anaesth. 2009 Jul;103(1):99-107
references.pmid: 19502286
references.citation: N Engl J Med. 2009 Sep 3;361(10):980-9
references.pmid: 19726772
references.citation: Anaesthesia. 2005 Aug;60(8):747-53
references.pmid: 16029222
references.citation: Lancet. 2008 May 31;371(9627):1839-47
references.pmid: 18479744
references.citation: Ann Surg. 2008 Jan;247(1):30-7
references.pmid: 18156920