Statin therapy in ambulatory populations is associated with a significant reduction in adverse cardiovascular events, including death and myocardial infarction.
Data about effects of statins on acute perioperative cardiovascular events are limited.

A study verified whether preoperative statin therapy is associated with a reduced risk of early cardiac death or nonfatal, in-hospital postoperative myocardial infarction after primary, elective coronary artery bypass graft surgery ( CABG ) requiring cardiopulmonary bypass.

The present study consisted of a pre-specified subset of patients, divided into two groups: patients receiving ( n = 1352 ) and not receiving ( n = 1314 ) preoperative statin therapy.

A total of 5436 patients, undergoing coronary artery bypass graft surgery, took part in The Multicenter Study of Perioperative Ischemia ( McSPI ) Epidemiology II Study, a prospective, longitudinal study.

Preoperative statin therapy was independently associated with a significant reduction ( adjusted odds ratio [OR] 0.25 ) in the risk of early cardiac death after primary, elective coronary bypass surgery ( 0.3% versus 1.4%; P < 0.03 ), but was not associated with a reduced risk of postoperative nonfatal, in-hospital myocardial infarction ( 7.9% versus 6.2%; P = not significant ).

Discontinuation of statin therapy after surgery was independently associated with a significant increase in late all-cause mortality ( adjusted OR 2.64 ) compared with continuation of statin therapy ( 2.64% versus 0.60%; P < 0.01 ).
Discontinuation of statin therapy after surgery was also independently associated with a significant increase in late cardiac mortality ( adjusted OR 2.95 ) compared with continuation of statin therapy ( 1.91% versus 0.45%; P < 0.01 ).

The study found that preoperative statin use is associated with reduced cardiac mortality after primary, elective coronary artery bypass grafting, and postoperative statin discontinuation is associated with increased in-hospital mortality.

These data suggest the importance of perioperative statin administration, according to authors.

Source: The Journal of Thoracic and Cardiovascular Surgery, 2006


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