Preoperative statin treatment is associated with reduced postoperative mortality after isolated cardiac valve surgery in high-risk patients.
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.
Allou
Nicolas
N
Département d'Anesthésie-Réanimation, Hôpital Bichat, Paris, France.
Augustin
Pascal
P
Dufour
Guillaume
G
Tini
Laura
L
Ibrahim
Hassan
H
Dilly
Marie-Pierre
MP
Montravers
Philippe
P
Wallace
Joshua
J
Provenchère
Sophie
S
Philip
Ivan
I
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
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors