title: Perioperative statin therapy.
abstract: BACKGROUND
  The lipid lowering class of drugs known as "Statins" are being increasing recognized for their pleiotropic effects which include anti-inflammation, antioxidant, vasodilatation, improved endothelial function and stabilization of atherosclerotic plaques. These effects may counteract, to some extent, the deleterious impact of surgical stress on various organ systems during the perioperative period.
  
  
  METHODS
  A literature review was undertaken to examine current evidence for the effect of perioperative statin use on postoperative morbidity and mortality. A search of PubMed, Medline and Scopus databases was performed using a combination of search terms including statins and perioperative risk reduction, outcomes, morbidity and mortality. Further searches were made on specific areas such as statins and thrombosis, kidney injury, renal protection, cancer, cost and safety.
  
  
  CONCLUSIONS
  Current evidence supports a reduction in cardiovascular morbidity and mortality associated with perioperative statin use in high risk patients undergoing non cardiac surgery and this represents a very cost effective application of statin therapy with few adverse events reported. Data is emerging that point to other benefits such as renal protection but this requires further confirmation from prospective studies. Future research needs to address the questions of the optimal type, timing and dosage of statin therapy as well as whether there are problems associated with abrupt withdrawal and adverse effects associated with long term use.
authors.affiliation: Queen Mary Hospital, Department of Anaesthesiology, Pokfulam Road, Hong Kong.
authors.forename: Wales W N
authors.initials: WW
authors.lastname: Chan
authors.forename: Gordon T C
authors.initials: GT
authors.lastname: Wong
authors.forename: Michael G
authors.initials: MG
authors.lastname: Irwin
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology / Q000517:prevention & control; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000517:prevention & control; D001792:Blood Platelets / Q000187:drug effects; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D003362:Cost-Benefit Analysis; D042783:Endothelial Cells / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000378:metabolism; D008055:Lipids / Q000097:blood; D009131:Muscle, Smooth, Vascular / Q000187:drug effects; D009369:Neoplasms / Q000503:physiopathology / Q000517:prevention & control; D059035:Perioperative Period / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D013927:Thrombosis / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D008055:Lipids