Document Detail

Midterm benefits of preoperative statin therapy in patients undergoing isolated valve surgery.
MedLine Citation:
PMID:  22632489     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Recent data have suggested that statins are associated with reduced early mortality and cardiovascular events after valvular heart surgery. The midterm effects of preoperative statin therapy in the setting of valvular heart surgery are presently unclear.
METHODS: All patients (n = 2,120) who underwent a valvular procedure between April 2004 and April 2010 were identified. Patients undergoing concomitant coronary artery bypass graft surgery were excluded. Two patient groups were studied: those who received preoperative statin therapy (n = 663; 31.3%) and those who did not (n = 1,457; 68.7%). Propensity score matching resulted in 381 matched pairs, thus addressing baseline risk imbalances. Thirty-day mortality, readmission rates, postoperative complications, and length of stay were analyzed. Late survival was ascertained by the Social Security Death Index.
RESULTS: In the matched group, 30-day mortality was 1.3% (5 of 381) for statin-treated patients versus 4.2% (16 of 381) for statin-untreated patients (p = 0.03). After a mean follow-up of 33 ± 23 months, statin therapy was associated with significantly reduced mortality (hazard ratio 0.63, 95% confidence interval: 0.43 to 0.93, p = 0.019), independent of known cardiac risk factors. Weighted log rank tests revealed that the mortality difference between the two cohorts occurred early after surgery (p = 0.015). Statin users were less likely to be readmitted to the intensive care unit (3.4% versus 8.1%, p = 0.01). There were no other significant differences between the two groups in terms of postoperative complications and length of stay.
CONCLUSIONS: Preoperative statin administration is associated with early reductions in mortality among patients undergoing isolated valvular heart surgery, leading to improved late survival. Future prospective analyses are warranted to optimize statin therapy in this patient population.
Muthiah Vaduganathan; Neil J Stone; Adin-Cristian Andrei; Richard Lee; Preeti Kansal; Robert A Silverberg; Robert O Bonow; Patrick M McCarthy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  93     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1881-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Divisions of Cardiothoracic Surgery and Cardiology, Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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