Early Statin Use May Reduce Complications Following Noncardiac Surgery

The use of a statin on the day before or the day after noncardiac surgery can significantly reduce the risk of complications after surgery, according to a new large cohort analysis.

Although statins may reduce perioperative complications, their use in patients undergoing noncardiac surgery is controversial. Therefore, the researchers in this study aimed to determine the efficacy of statin use before and immediately after noncardiac surgery.
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From October 1, 2005, to September 30, 2010, the researchers collected data from the Veterans Affairs Surgical Quality Improvement Program (VASQIP) on 180,478 veterans who underwent noncardiac surgery—such as vascular, general, or orthopedic—and were admitted within 7 days of surgery to Department of Veterans Affairs hospitals.

The researchers tracked 30-day postoperative follow-ups for all-cause mortality and cardiovascular and noncardiovascular outcomes and statin use on the day of or the day after surgery.

Of the total 180,478 patients included in the analysis, 96,486 were included in the propensity-score–matched cohort.

About 37.8% of patients had an outpatient prescription for a statin at the time of hospital admission, and 31.5% had been exposed to a statin on the day of or the day after surgery.

The 30-day all-cause mortality risk was significantly reduced in patients who were taking statins during early perioperative stages.

Secondary analysis found that early statin exposure was associated with a reduced risk of any complication, with the greatest risk reduction for cardiac complications.

“Early perioperative exposure to a statin was associated with a significant reduction in all-cause perioperative mortality and several cardiovascular and noncardiovascular complications,” the researchers concluded. “However, the potential for selection biases in these results must be considered.”

—Amanda Balbi

Reference:

London MJ, Schwartz GG, Hur K, Henderson WG. Association of perioperative statin use with mortality and morbidity after major noncardiac surgery [published online December 19, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2016.8005.