title: Effects of preoperative statin use on perioperative outcomes of carotid endarterectomy.
abstract: Several studies have shown the beneficial role of statins in reducing the risk of major perioperative complications and death associated with noncardiac vascular surgery, but few have focused on their effects in the event of carotid endarterectomy (CEA). This study analyzes the effects of preoperative statin use on perioperative outcomes in patients undergoing CEA.
  
  
  
  Data from all consecutive patients who underwent primary CEA for symptomatic and asymptomatic carotid disease between 2002 and 2014 at a single institution were prospectively stored in a vascular surgery registry, recording risk factors, medication, and indication for surgery. Endpoints of the study were perioperative (30-day) stroke and death.
  
  
  
  Overall, 784 patients were on statins (825 CEAs, Group I), while 494 were not (545 CEAs, Group II). There were two perioperative strokes in Group I (0.24%) and four in Group II (0.73%;p= .22), and no deaths. The only nonfatal cardiac complication occurred in Group II (0.18%,p= .39). A neurologist assessed patients at 1, 6, and 12 months after CEA, and every 2 years thereafter. Follow-up (range: 0.1-13 years; mean, 6.3 ± 3.7 years) was obtained for 1,239 patients (1,326 CEAs). Because 165 patients (166 CEAs) crossed over from Group II to Group I during the follow-up time, long-term data were stratified by postoperative statin treatment rather than by preoperative statin use. The 5- and 10-year restenosis/occlusion and survival rates did not differ significantly between the two groups.
  
  
  
  Taking statins prior to CEA did not seem to affect the risk of major perioperative ischemic events and death, most likely due to the extremely low overall incidence of perioperative complications.
authors.affiliation: The Vascular Surgery Group Department of Surgical Oncological and Gastroenterological Sciences School of Medicine University of Padua Padova Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Ballotta
authors.affiliation: The Vascular Surgery Group Department of Surgical Oncological and Gastroenterological Sciences School of Medicine University of Padua Padova Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Toniato
authors.affiliation: Stroke Unit and Neurosonology Laboratory Department of Neurosciences School of Medicine University of Padua Padova Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Farina
authors.affiliation: Stroke Unit and Neurosonology Laboratory Department of Neurosciences School of Medicine University of Padua Padova Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Baracchini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016894:Endarterectomy, Carotid / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D007431:Intraoperative Complications / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D057234:Preoperative Period; D012042:Registries; D020521:Stroke / Q000401:mortality / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: carotid endarterectomy; carotid restenosis; eversion technique; statin therapy; stroke