Document Detail


Effect of perioperative statins on death, myocardial infarction, atrial fibrillation, and length of stay: a systematic review and meta-analysis.
MedLine Citation:
PMID:  22351917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the influence of perioperative statin treatment on the risk of death, myocardial infarction, atrial fibrillation, and hospital and intensive care unit length of stay in statin-naive patients undergoing cardiac or noncardiac surgery.
DATA SOURCES: MEDLINE via PubMed, EMBASE, Biosis, and the Cochrane Central Register of Controlled Trials via Ovid. Additional studies were identified through hand searches of bibliographies, trial Web sites, and clinical experts. Randomized controlled trials reporting the effect of perioperative statins in statin-naive patients undergoing cardiac and noncardiac surgery were included.
STUDY SELECTION: Two investigators independently selected eligible studies from original research published in any language studying the effects of statin use on perioperative outcomes of interest.
DATA EXTRACTION: Two investigators performed independent article abstraction and quality assessment.
DATA SYNTHESIS: Fifteen randomized controlled studies involving 2292 patients met the eligibility criteria. Random-effects meta-analyses of unadjusted and adjusted data were performed according to the method described by DerSimonian and Laird. Perioperative statin treatment decreased the risk of atrial fibrillation in patients undergoing cardiac surgery (relative risk [RR], 0.56; 95% CI, 0.45 to 0.69; number needed to treat [NNT], 6). In cardiac and noncardiac surgery, perioperative statin treatment reduced the risk of myocardial infarction (RR, 0.53; 95% CI, 0.38 to 0.74; NNT, 23) but not the risk of death (RR, 0.62; 95% CI, 0.34 to 1.14). Statin treatment reduced mean length of hospital stay (standardized mean difference, -0.32; 95% CI, -0.53 to -0.11) but had no effect on length of intensive care unit stay (standardized mean difference, -0.08; 95% CI, -0.25 to 0.10).
CONCLUSIONS: Perioperative statin treatment in statin-naive patients reduces atrial fibrillation, myocardial infarction, and duration of hospital stay. Wider use of statins to improve cardiac outcomes in patients undergoing high-risk procedures seems warranted.
Authors:
Vineet Chopra; David H Wesorick; Jeremy B Sussman; Todd Greene; Mary Rogers; James B Froehlich; Kim A Eagle; Sanjay Saint
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  147     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-21     Completed Date:  2012-04-10     Revised Date:  2012-08-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-9     Citation Subset:  AIM; IM    
Affiliation:
Division of General Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109, USA. vineetc@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / epidemiology,  prevention & control*
Cardiac Surgical Procedures* / adverse effects
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Length of Stay*
Myocardial Infarction / epidemiology,  prevention & control*
Perioperative Care
Postoperative Complications / prevention & control
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections
Comment In:
Ann Intern Med. 2012 Jun 19;156(12):JC6-2   [PMID:  22711103 ]
Arch Surg. 2012 Feb;147(2):189   [PMID:  22351918 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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