Effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery

Minoru Tabata, Zain I Khalpey, Lawrence H. Cohn, Fredrick Y. Chen, R. Morton Bolman, James D. Rawn

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to have pleiotropic effects in addition to their lipid-lowering properties. Some studies have shown the beneficial effect of preoperative statins on operative outcomes in coronary artery bypass grafting. However, the effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery remains poorly defined. Methods: We performed a retrospective review of 1389 consecutive patients undergoing cardiac valve surgery between January of 2002 and December of 2005. Patients undergoing concomitant coronary artery bypass surgery and those with a history of myocardial infarction and coronary interventions were excluded. Of this cohort, 363 patients were receiving a statin preoperatively and 1026 patients were not. Propensity scores were constructed with patients' demographics, clinical data, and the year of procedure. Generalized estimating equations, including the propensity score as a covariate, were used to investigate whether preoperative statin use is associated with improved operative outcomes. Results: The crude operative mortality rate was 0.8% and 2.3%, the incidence of stroke was 1.7% and 2.9%, and the incidence of perioperative myocardial infarction was 2.2% and 2.4% in the statin and non-statin groups, respectively. Generalized estimating equations showed that preoperative statin use is associated with lower mortality (odds ratio: 0.25, 95% confidential interval: 0.12-0.54). Preoperative statin use was not significantly associated with an incidence of stroke (odds ratio: 0.48, 95% confidential interval: 0.19-1.22) or perioperative myocardial infarction (odds ratio: 0.91, 95% confidential interval: 0.43-1.91) in this cohort. Conclusion: Preoperative use of statins may improve operative outcomes in patients without coronary artery disease who undergo cardiac surgery.

Original languageEnglish (US)
Pages (from-to)1510-1513
Number of pages4
JournalJournal of Thoracic and Cardiovascular Surgery
Volume136
Issue number6
DOIs
StatePublished - Dec 2008
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Thoracic Surgery
Coronary Artery Disease
Propensity Score
Odds Ratio
Myocardial Infarction
Coronary Artery Bypass
Incidence
Stroke
Mortality
Heart Valves
Oxidoreductases
Demography
Lipids

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery. / Tabata, Minoru; Khalpey, Zain I; Cohn, Lawrence H.; Chen, Fredrick Y.; Bolman, R. Morton; Rawn, James D.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 136, No. 6, 12.2008, p. 1510-1513.

Research output: Contribution to journalArticle

Tabata, Minoru ; Khalpey, Zain I ; Cohn, Lawrence H. ; Chen, Fredrick Y. ; Bolman, R. Morton ; Rawn, James D. / Effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery. In: Journal of Thoracic and Cardiovascular Surgery. 2008 ; Vol. 136, No. 6. pp. 1510-1513.
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abstract = "Objective: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to have pleiotropic effects in addition to their lipid-lowering properties. Some studies have shown the beneficial effect of preoperative statins on operative outcomes in coronary artery bypass grafting. However, the effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery remains poorly defined. Methods: We performed a retrospective review of 1389 consecutive patients undergoing cardiac valve surgery between January of 2002 and December of 2005. Patients undergoing concomitant coronary artery bypass surgery and those with a history of myocardial infarction and coronary interventions were excluded. Of this cohort, 363 patients were receiving a statin preoperatively and 1026 patients were not. Propensity scores were constructed with patients' demographics, clinical data, and the year of procedure. Generalized estimating equations, including the propensity score as a covariate, were used to investigate whether preoperative statin use is associated with improved operative outcomes. Results: The crude operative mortality rate was 0.8{\%} and 2.3{\%}, the incidence of stroke was 1.7{\%} and 2.9{\%}, and the incidence of perioperative myocardial infarction was 2.2{\%} and 2.4{\%} in the statin and non-statin groups, respectively. Generalized estimating equations showed that preoperative statin use is associated with lower mortality (odds ratio: 0.25, 95{\%} confidential interval: 0.12-0.54). Preoperative statin use was not significantly associated with an incidence of stroke (odds ratio: 0.48, 95{\%} confidential interval: 0.19-1.22) or perioperative myocardial infarction (odds ratio: 0.91, 95{\%} confidential interval: 0.43-1.91) in this cohort. Conclusion: Preoperative use of statins may improve operative outcomes in patients without coronary artery disease who undergo cardiac surgery.",
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T1 - Effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery

AU - Tabata, Minoru

AU - Khalpey, Zain I

AU - Cohn, Lawrence H.

AU - Chen, Fredrick Y.

AU - Bolman, R. Morton

AU - Rawn, James D.

PY - 2008/12

Y1 - 2008/12

N2 - Objective: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to have pleiotropic effects in addition to their lipid-lowering properties. Some studies have shown the beneficial effect of preoperative statins on operative outcomes in coronary artery bypass grafting. However, the effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery remains poorly defined. Methods: We performed a retrospective review of 1389 consecutive patients undergoing cardiac valve surgery between January of 2002 and December of 2005. Patients undergoing concomitant coronary artery bypass surgery and those with a history of myocardial infarction and coronary interventions were excluded. Of this cohort, 363 patients were receiving a statin preoperatively and 1026 patients were not. Propensity scores were constructed with patients' demographics, clinical data, and the year of procedure. Generalized estimating equations, including the propensity score as a covariate, were used to investigate whether preoperative statin use is associated with improved operative outcomes. Results: The crude operative mortality rate was 0.8% and 2.3%, the incidence of stroke was 1.7% and 2.9%, and the incidence of perioperative myocardial infarction was 2.2% and 2.4% in the statin and non-statin groups, respectively. Generalized estimating equations showed that preoperative statin use is associated with lower mortality (odds ratio: 0.25, 95% confidential interval: 0.12-0.54). Preoperative statin use was not significantly associated with an incidence of stroke (odds ratio: 0.48, 95% confidential interval: 0.19-1.22) or perioperative myocardial infarction (odds ratio: 0.91, 95% confidential interval: 0.43-1.91) in this cohort. Conclusion: Preoperative use of statins may improve operative outcomes in patients without coronary artery disease who undergo cardiac surgery.

AB - Objective: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to have pleiotropic effects in addition to their lipid-lowering properties. Some studies have shown the beneficial effect of preoperative statins on operative outcomes in coronary artery bypass grafting. However, the effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery remains poorly defined. Methods: We performed a retrospective review of 1389 consecutive patients undergoing cardiac valve surgery between January of 2002 and December of 2005. Patients undergoing concomitant coronary artery bypass surgery and those with a history of myocardial infarction and coronary interventions were excluded. Of this cohort, 363 patients were receiving a statin preoperatively and 1026 patients were not. Propensity scores were constructed with patients' demographics, clinical data, and the year of procedure. Generalized estimating equations, including the propensity score as a covariate, were used to investigate whether preoperative statin use is associated with improved operative outcomes. Results: The crude operative mortality rate was 0.8% and 2.3%, the incidence of stroke was 1.7% and 2.9%, and the incidence of perioperative myocardial infarction was 2.2% and 2.4% in the statin and non-statin groups, respectively. Generalized estimating equations showed that preoperative statin use is associated with lower mortality (odds ratio: 0.25, 95% confidential interval: 0.12-0.54). Preoperative statin use was not significantly associated with an incidence of stroke (odds ratio: 0.48, 95% confidential interval: 0.19-1.22) or perioperative myocardial infarction (odds ratio: 0.91, 95% confidential interval: 0.43-1.91) in this cohort. Conclusion: Preoperative use of statins may improve operative outcomes in patients without coronary artery disease who undergo cardiac surgery.

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