Document Detail

Effect of preoperative statin therapy on patients undergoing isolated and combined valvular heart surgery.
MedLine Citation:
PMID:  20172126     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is unknown whether patients undergoing valve surgery benefit from preoperative statin therapy. We examined the effects of statin treatment in a large group of patients undergoing valve surgery.
METHODS: Between October 2001 and May 2008, a total of 10,061 patients underwent isolated or combined valve surgery at our institution. Patients were divided into those who received preoperative statin therapy (group 1, n = 4,216) versus those who did not receive statin therapy (group 2, n = 5,538). Patients in whom preoperative statin therapy status was unknown (n = 307) were excluded. Follow-up survival information was available in all patients.
RESULTS: Group 1 patients had more comorbidities, were more likely to undergo concomitant coronary artery bypass grafting (46.0% versus 20.7%; p < 0.001), and had a higher mean EuroSCORE predicted risk of mortality (12.4% +/- 13.5% versus 11.5% +/- 13.9%; p = 0.002). Patients receiving preoperative statin therapy had a higher incidence of low cardiac output syndrome (8.4% versus 6.0%; p < 0.001) and the combined cardiac outcome of myocardial infarction, low cardiac output syndrome, and 30-day mortality (11.8% versus 9.6%; p < 0.001) by univariate analysis. Multivariable analyses, however, revealed no significant effect of statin therapy on perioperative cardiac outcomes. Cox multivariable regression revealed no significant effect of statin therapy on long-term survival in the entire patient cohort, but statin therapy was associated with a long-term survival benefit (hazard ratio, 0.81; 95% confidence interval, 0.70 to 0.93; p = 0.003) in patients who underwent concomitant coronary artery bypass grafting.
CONCLUSIONS: Our large series failed to detect a protective effect of preoperative statin therapy on perioperative outcomes or long-term survival in patients undergoing isolated valve surgery. Valve patients undergoing concomitant coronary artery bypass grafting, however, appear to receive a long-term survival benefit from statins.
Michael A Borger; Joerg Seeburger; Thomas Walther; Franka Borger; Ardawan Rastan; Torsten Doenst; Friedrich W Mohr
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-03-16     Revised Date:  2011-04-01    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  773-9; discussion 779-80     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiac Surgery, Leipzig Heart Center, Struempellstrasse 39, 04289 Leipzig, Germany.
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MeSH Terms
Cardiac Surgical Procedures / mortality
Coronary Artery Bypass
Heart Valves / surgery*
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Middle Aged
Postoperative Complications
Preoperative Care*
Survival Rate
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comment In:
Ann Thorac Surg. 2011 Mar;91(3):983-4   [PMID:  21353045 ]

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

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