title: Preoperative statin therapy decreases early mortality in patients undergoing isolated valve surgery: result from a meta-analysis.
abstract: OBJECTIVE
  The purpose of this meta-analysis was to assess the role of preoperative statin therapy on adverse cardiovascular events in patients undergoing valve surgery.
  
  
  METHODS
  Meta-analysis of 10 observational studies.
  
  
  METHODS
  Hospital.
  
  
  METHODS
  22,158 patients.
  
  
  METHODS
  None.
  
  
  RESULTS
  The Medline, Cochrane, and Embase databases were searched for clinical studies published up to June 2014. Studies that evaluated the effects of preoperative statin therapy on valve surgery were included. After a literature search in the major databases, 10 observational studies with 22,518 patients were identified. Pool analysis indicated that preoperative statin therapy was associated with a significantly lower risk of early all-cause mortality (Odds ratio [OR]: 0.69; 95% confidence interval [CI] 0.50-0.95, p = 0.03). The benefits of preoperative statin therapy were more obvious in studies with isolated valve surgery, resulting in a 1.9% absolute risk and a 38% odds reduction of early mortality (2.4 v 4.3%; OR: 0.62; 95% CI 0.49-0.77, p<0.0001). A significant reduction by statin therapy also was observed for atrial fibrillation (OR 0.88, 95% CI: 0.80-0.98, p = 0.02). However, statin therapy was not associated with a lower risk of postoperative stroke (OR: 0.74; 95% CI 0.46-1.19, p = 0.21), myocardial infarction (OR: 1.02; 95% CI 0.78-1.34, p = 0.87), and renal failure (OR: 0.91; 95% CI 0.57-1.44, p = 0.68).
  
  
  CONCLUSIONS
  Preoperative statin therapy was associated with a significantly lower risk of early mortality in patients undergoing isolated valve surgery. A prospective, randomized, controlled trial is warranted.
authors.affiliation: Department of Cardiology, Banan People's Hospital of Chongqing. Electronic address: chengxiao860203@126.com.
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Clinical laboratory, The Third People׳s Hospital of Chongqing.
authors.forename: Qiongwen
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital / The Second Clinical Institute, Chongqing Medical University, Chongqing, China.
authors.forename: Zengzhang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Banan People's Hospital of Chongqing. Electronic address: tangxuewen666@163.com.
authors.forename: Xuewen
authors.initials: X
authors.lastname: Tang
mesh_terms: D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D064887:Observational Studies as Topic / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality* / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: meta-analysis; mortality; statin; valve surgery