Statins and noncardiac surgery: current evidence and practical considerations
- PMID: 19880840
- DOI: 10.3949/ccjm.76.s4.13
Statins and noncardiac surgery: current evidence and practical considerations
Abstract
Vascular surgery is associated with a high risk of perioperative morbidity and mortality that is partly attributable to inflammatory stress induced by the surgical procedure. Preoperative initiation of a long-acting statin is a strategy intended to reduce the inflammatory stress response and the excess risk associated with vascular surgery. The Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echo III demonstrated significant reductions in perioperative myocardial ischemia and the composite end point of myocardial infarction or cardiovascular death with extended-release fluvastatin (relative to placebo) initiated 30 days prior to vascular surgery. These benefits were achieved with no increase in liver dysfunction, evidence of myopathy, or other side effects. Observational data suggest that perioperative statin use is associated with improved recovery from acute kidney injury after high-risk vascular surgery and with improved long-term survival in patients undergoing such surgery.
Similar articles
-
[Organprotection in cardiac risk patients--rational of perioperative beta-adrenoceptor-antagonists and statins].Anasthesiol Intensivmed Notfallmed Schmerzther. 2010 Apr;45(4):246-52; quiz 253. doi: 10.1055/s-0030-1253093. Epub 2010 Apr 12. Anasthesiol Intensivmed Notfallmed Schmerzther. 2010. PMID: 20387182 Review. German.
-
Fluvastatin and perioperative events in patients undergoing vascular surgery.N Engl J Med. 2009 Sep 3;361(10):980-9. doi: 10.1056/NEJMoa0808207. N Engl J Med. 2009. PMID: 19726772 Clinical Trial.
-
Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASE-IV).Ann Surg. 2009 Jun;249(6):921-6. doi: 10.1097/SLA.0b013e3181a77d00. Ann Surg. 2009. PMID: 19474688 Clinical Trial.
-
Statin use is associated with early recovery of kidney injury after vascular surgery and improved long-term outcome.Nephrol Dial Transplant. 2008 Dec;23(12):3867-73. doi: 10.1093/ndt/gfn381. Epub 2008 Jul 15. Nephrol Dial Transplant. 2008. PMID: 18628367
-
Preoperative cardiovascular evaluation for noncardiac surgery.Mt Sinai J Med. 2005 May;72(3):185-92. Mt Sinai J Med. 2005. PMID: 15915313 Review.
Cited by
-
Direct inpatient costs and influencing factors for patients with rectal cancer with low anterior resection: a retrospective observational study at a three-tertiary hospital in Beijing, China.BMJ Open. 2018 Dec 18;8(12):e023116. doi: 10.1136/bmjopen-2018-023116. BMJ Open. 2018. PMID: 30567822 Free PMC article.
-
Perioperative statin therapy for improving outcomes during and after noncardiac vascular surgery.Cochrane Database Syst Rev. 2013 Jul 3;2013(7):CD009971. doi: 10.1002/14651858.CD009971.pub2. Cochrane Database Syst Rev. 2013. PMID: 23824754 Free PMC article. Review.
-
Statin use and postoperative atrial fibrillation after major noncardiac surgery.Heart Rhythm. 2012 Feb;9(2):163-9. doi: 10.1016/j.hrthm.2011.09.003. Epub 2011 Sep 9. Heart Rhythm. 2012. PMID: 21907173 Free PMC article.
-
Perioperative protective effects of statins.F1000 Med Rep. 2010 May 11;2:35. doi: 10.3410/M2-35. F1000 Med Rep. 2010. PMID: 20948850 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
