title: Impact of preoperative statin therapy on adverse postoperative outcomes in patients undergoing vascular surgery.
abstract: BACKGROUND
  Chronic statin therapy is associated with reduced postoperative mortality. Renal and cardiovascular benefits have been described, but the effect of chronic statin therapy on postoperative adverse events has not yet been explored.
  
  
  METHODS
  In this observational study involving 1,674 patients undergoing aortic reconstruction, we prospectively assessed chronic statin therapy compared with no statin therapy, with regard to serious outcomes, by propensity score and multivariable methods.
  
  
  RESULTS
  In propensity-adjusted multivariable logistic regression (c-index: 0.83), statins were associated with an almost threefold reduction in the risk of death in patients undergoing major vascular surgery (odds ratio: 0.40; 95% CI: 0.28-0.59) and an almost twofold reduction in the risk of postoperative myocardial infarction (odds ratio: 0.52; 95% CI: 0.38-0.71). Likewise, the use of chronic statin therapy was associated with a reduced risk of postoperative stroke and renal failure. Statins did not significantly reduce the risk of pneumonia, multiple organ dysfunction syndrome, and surgical complications; however, in the case of postoperative multiple organ dysfunction syndrome (odds ratio: 0.34; 95% CI: 0.12-0.94) and surgical complications (odds ratio: 0.39; 95% CI: 0.17-0.86), reduced mortality was observed.
  
  
  CONCLUSIONS
  Chronic statin therapy was associated with a reduction in all cardiac and vascular outcomes after major vascular surgery. Furthermore, in major adverse events, such as multiple organ dysfunction syndrome and surgical complications, statins were also associated with decreased mortality.
authors.affiliation: Department of Anesthesiology, and Critical Care, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Paris Cedex 13, France. yannick.le-manach@psl.ap-hop-paris.fr
authors.forename: Yannick
authors.initials: Y
authors.lastname: Le Manach
authors.forename: Cristina
authors.initials: C
authors.lastname: Ibanez Esteves
authors.forename: Michelle
authors.initials: M
authors.lastname: Bertrand
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Goarin
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Fléron
authors.forename: Pierre
authors.initials: P
authors.lastname: Coriat
authors.forename: Fabien
authors.initials: F
authors.lastname: Koskas
authors.forename: Bruno
authors.initials: B
authors.lastname: Riou
authors.forename: Paul
authors.initials: P
authors.lastname: Landais
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D009102:Multiple Organ Failure / Q000517:prevention & control; D009203:Myocardial Infarction / Q000517:prevention & control; D016017:Odds Ratio; D011014:Pneumonia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000517:prevention & control; D020521:Stroke / Q000517:prevention & control; D016019:Survival Analysis; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors