title: Preoperative statin treatment is associated with reduced postoperative mortality after isolated cardiac valve surgery in high-risk patients.
abstract: OBJECTIVE
  The aim of the present study was to assess the influence of preoperative statin therapy on postoperative mortality in high-risk patients after isolated valve surgery.
  
  
  METHODS
  An observational cohort study.
  
  
  METHODS
  A 1,200-bed university hospital.
  
  
  METHODS
  All consecutive patients undergoing isolated nonemergent valve surgery with cardiopulmonary bypass between November 2005 and December 2007 were included.
  
  
  METHODS
  None.
  
  
  RESULTS
  During the period, 772 consecutive patients underwent nonemergent isolated valve surgery. Among them, 430 were high cardiovascular risk (defined by patients with 2 or more cardiovascular risk factors). In the high-risk cardiovascular patients, statin pretreatment was administered in 222 patients (52%). In multivariate analysis, after adjustment with a propensity score analysis, preoperative statin therapy was associated with a significant reduction of postoperative mortality in patients with high risk (odds ratio = 0.41; 95% confidence interval, 0.17-0.97; p = 0.04). Low left ventricular ejection fraction and elevated pulmonary artery pressure also were independently associated with increased postoperative mortality. By contrast, in the low-risk patient group, few patients received preoperative statin therapy (7%).
  
  
  CONCLUSIONS
  This study suggests that preoperative statin therapy may have a potential beneficial effect on postoperative mortality after isolated cardiac valve surgery in high-risk cardiovascular patients.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital Bichat, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Allou
authors.forename: Pascal
authors.initials: P
authors.lastname: Augustin
authors.forename: Guillaume
authors.initials: G
authors.lastname: Dufour
authors.forename: Laura
authors.initials: L
authors.lastname: Tini
authors.forename: Hassan
authors.initials: H
authors.lastname: Ibrahim
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Dilly
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Joshua
authors.initials: J
authors.lastname: Wallace
authors.forename: Sophie
authors.initials: S
authors.lastname: Provenchère
authors.forename: Ivan
authors.initials: I
authors.lastname: Philip
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D002315:Cardiopulmonary Bypass; D002318:Cardiovascular Diseases / Q000150:complications; D002423:Cause of Death; D015331:Cohort Studies; D023381:Endpoint Determination; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control*; D011300:Preoperative Care; D057216:Propensity Score; D012306:Risk; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors