Perioperative Statin Therapy Is Associated With a Significant and Dose-Dependent Reduction of Adverse Cardiovascular Outcomes After Coronary Artery Bypass Graft Surgery
| Autor: | Alexandre Ouattara, Yannick Le Manach, Bruno Riou, Omar Itani, Amer Osman, Pierre Coriat, Hamina Benhaoua, Nejma Mabrouk-Zerguini, Marc Landi |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Statin medicine.drug_class Perioperative Care law.invention Cohort Studies Postoperative Complications Randomized controlled trial law Internal medicine medicine Humans Prospective Studies Coronary Artery Bypass Aged Dose-Response Relationship Drug business.industry Odds ratio Perioperative Middle Aged medicine.disease Cardiac surgery Surgery Regimen Treatment Outcome Anesthesiology and Pain Medicine Cardiovascular Diseases Heart failure Propensity score matching Cardiology Female Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 23:633-638 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2009.02.008 |
| Popis: | The aim of this study was to determine whether perioperative statin therapy was associated with a dose-dependent decrease in adverse cardiovascular events after coronary artery bypass graft (CABG) surgery.A prospective observational study.A cardiovascular anesthesia unit in a university hospital.Four hundred eighteen consecutive patients undergoing CABG surgery between October 2004 and October 2005.Patients were divided in 2 groups depending on whether their preoperative treatment included statins or not. In patients receiving statins, high- and low-dose regimens were respectively defined as a regimen recognized to induce a theoretic reduction of low-density lipoprotein cholesterol level equal to 45% (n = 87) or45% (n = 258). In treated patients, statin therapy was maintained until the day of surgery and was restarted soon thereafter.The measured endpoint was adverse in-hospital cardiovascular outcomes including heart failure and/or malignant arrhythmia and/or cardiac death. Stepwise logistic regression and a multivariate analysis of propensity-matched cohort were used for analysis of the findings. After adjustment for propensity score, statin therapy was found to produce a significant reduction in cardiovascular outcomes (odds ratio = 0.56; 95% confidence interval [CI], 0.32-0.96, p0.05). By using multivariate analysis, the odds ratio for cardiovascular outcomes in patients receiving high-dose statins compared with those treated by low-dose statins was 0.62 (95% CI, 0.41-0.93; p0.05).Statin therapy is associated with a significant and dose-dependent reduction in adverse cardiovascular events after CABG surgery. However, further randomized trials still require confirming a causal association between statins and better postoperative outcomes and evaluating the tolerance of such perioperative therapy. |
| Databáze: | OpenAIRE |
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