title: Statins improve outcome in isolated heart valve operations: a propensity score analysis of 3,217 patients.
abstract: BACKGROUND
  Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed.
  
  
  METHODS
  Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias.
  
  
  RESULTS
  The overall 30-day mortality rate was 2.7%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32 to 0.89; p=0.001), postoperative cardiac arrhythmias (OR, 0.76; 95% CI, 0.62 to 0.93; p<0.006), and stroke (OR, 0.54; 95% CI, 0.32 to 0.92; p=0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (χ2, 4.41; hazard ratio [HR], 1.59; 95% CI, 1.13 to 2.27; p=0.03), stroke (χ2, 11.42; HR, 2.15; 95% CI, 1.37 to 3.27; p=0.0007), cardiac arrhythmias (χ2, 19.9; HR, 2.13; 95% CI, 1.81 to 2.72; p<0.0001), and major adverse cardiac and cerebrovascular events (χ2, 3.74; HR, 1.37; 95% CI, 0.99 to 1.74; p=0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up.
  
  
  CONCLUSIONS
  Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations.
authors.affiliation: Academic Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, United Kingdom. emilianoangeloni@gmail.com
authors.forename: Emiliano
authors.initials: E
authors.lastname: Angeloni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Melina
authors.forename: Umberto
authors.initials: U
authors.lastname: Benedetto
authors.forename: Simone
authors.initials: S
authors.lastname: Refice
authors.forename: Paolo
authors.initials: P
authors.lastname: Bianchi
authors.forename: Cesare
authors.initials: C
authors.lastname: Quarto
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sinatra
authors.forename: John R
authors.initials: JR
authors.lastname: Pepper
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors