Perioperative statin therapy in patients at high risk for cardiovascular morbidity undergoing surgery: a review

Statins feature documented benefits for primary and secondary prevention of cardiovascular disease and are thought to improve perioperative outcomes in patients undergoing surgery. To assess the clinical outcomes of perioperative statin treatment in statin-naive patients undergoing surgery, a systematic review was performed. Studies were included if they met the following criteria: randomized controlled trials, patients aged ≥18 yr undergoing surgery, patients not already on long-term statin treatment, reported outcomes including at least one of the following: mortality, myocardial infarction, atrial fibrillation, stroke, and length of hospital stay. The following randomized clinical trials were excluded: retrospective studies, trials without surgical procedure, trials without an outcome of interest, studies with patients on statin therapy before operation, or papers not written in English. The literature search revealed 16 randomized controlled studies involving 2275 patients. Pooled results showed a significant reduction in (i) mortality [risk ratio (RR) 0.53, 95% confidence interval (CI) 0.30–0.94, P=0.03], (ii) myocardial infarction (RR 0.54, 95% CI 0.38–0.76, P<0.001), (iii) perioperative atrial fibrillation (RR 0.53, 95% CI 0.43–0.66, P<0.001), and (iv) length of hospital stay (days, mean difference –0.58, 95% CI –0.79 to –0.37, P<0.001) in patients treated with a statin. Subgroup analysis in patients undergoing non-cardia...
Source: British Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Review Articles Source Type: research