title: Statins reduce neurologic injury in asymptomatic carotid endarterectomy patients.
abstract: OBJECTIVE
  Statins are neuroprotective in a variety of experimental models of cerebral injury. We sought to determine whether patients taking statins before asymptomatic carotid endarterectomy exhibit a lower incidence of neurological injury (clinical stroke and cognitive dysfunction).
  
  
  METHODS
  A total of 328 patients with asymptomatic carotid stenosis scheduled for elective carotid endarterectomy consented to participate in this observational study of perioperative neurological injury.
  
  
  RESULTS
  Patients taking statins had a lower incidence of clinical stroke (0.0% vs 3.1%; P=0.02) and cognitive dysfunction (11.0% vs 20.2%; P=0.03). In a multivariate regression model, statin use was significantly associated with decreased odds of cognitive dysfunction (odds ratio, 0.51 [95% CI, 0.27-0.96]; P=0.04).
  
  
  CONCLUSIONS
  Preoperative statin use was associated with less neurological injury after asymptomatic carotid endarterectomy. These observations suggest that it may be possible to further reduce the perioperative morbidity of carotid endarterectomy. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00597883.
authors: Department of Anesthesiology, Columbia University, New York, NY, USA. ejh3@columbia.edu
authors: Eric J
authors: EJ
authors: Heyer
authors: Joanna L
authors: JL
authors: Mergeche
authors: Samuel S
authors: SS
authors: Bruce
authors: Justin T
authors: JT
authors: Ward
authors: Yaakov
authors: Y
authors: Stern
authors: Zirka H
authors: ZH
authors: Anastasian
authors: Donald O
authors: DO
authors: Quest
authors: Robert A
authors: RA
authors: Solomon
authors: George J
authors: GJ
authors: Todd
authors: Alan I
authors: AI
authors: Benvenisty
authors: James F
authors: JF
authors: McKinsey
authors: Roman
authors: R
authors: Nowygrod
authors: Nicholas J
authors: NJ
authors: Morrissey
authors: E Sander
authors: ES
authors: Connolly
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications* / Q000188:drug therapy*; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000150:complications / Q000517:prevention & control; D016017:Odds Ratio; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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