Day-Of Statin Use Improves Outcomes Following CABG

Taking statins in the 24 hours before coronary artery bypass grafting (CABG) is associated with better outcomes than taking statins earlier or not at all, according to the results of a retrospective study.

Although preoperative statin therapy has been associated with reduced mortality risk following CABG, the optimal dose and timing are unknown.
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In order to explore this issue further, researchers conducted a retrospective review of data from 3025 primary isolated CABG patients. The patients were divided into 3 groups: those who received statins 24 hours or less before surgery, 24 to 72 hours beforehand, or more than 72 hours before the operation or who never took statins. Patients were also grouped by preoperative dose of statin.

Overall, 30-day all-cause mortality was significantly lower in patients taking statins 24 hours or less preoperatively compared with those taking statins 24 to 72 hours, more than 72 hours, or not taking statins before the operation.

For preoperative dose, mortality was significantly lower when taking 20 mg or less or more than 20 mg atorvastatin or equivalent than when taking no statins. In multivariate analysis of the propensity-matched cohort, more than 20 mg preoperative dose was associated with a 68% reduction of 30-day all-cause mortality compared with no preoperative statin. A dose of 20 mg or less preoperative dose showed no association with mortality reduction.

“Both statin use 24 hours or less preoperatively and preoperative statin dose of more than 20 mg were independently associated with decreased 30-day all-cause mortality after coronary  artery bypass graft surgery,” the researchers concluded.

—Michael Potts

Reference:

Curtis M, Deng Y, Lee V, et al. Effect of dose and timing of preoperative statins on mortality after coronary artery bypass surgery [published online March 16, 2017]. Ann Thorac Surg. doi: dx.doi.org/10.1016/j.athoracsur.2016.12.043.