Preoperative Statin Treatment Is Associated With Reduced Postoperative Mortality After Isolated Cardiac Valve Surgery in High-Risk Patients
Presented in part at the 50th Annual Congress of the French Society of Anesthesiologists, Paris, France, September 24-27, 2008.
published online 20 July 2010. Corrected Proof
Objective
The aim of the present study was to assess the influence of preoperative statin therapy on postoperative mortality in high-risk patients after isolated valve surgery.
Design
An observational cohort study.
Setting
A 1,200-bed university hospital.
Participants
All consecutive patients undergoing isolated nonemergent valve surgery with cardiopulmonary bypass between November 2005 and December 2007 were included.
Intervention
None.
Measurements and Main Results
During the period, 772 consecutive patients underwent nonemergent isolated valve surgery. Among them, 430 were high cardiovascular risk (defined by patients with 2 or more cardiovascular risk factors). In the high-risk cardiovascular patients, statin pretreatment was administered in 222 patients (52%). In multivariate analysis, after adjustment with a propensity score analysis, preoperative statin therapy was associated with a significant reduction of postoperative mortality in patients with high risk (odds ratio = 0.41; 95% confidence interval, 0.17-0.97; p = 0.04). Low left ventricular ejection fraction and elevated pulmonary artery pressure also were independently associated with increased postoperative mortality. By contrast, in the low-risk patient group, few patients received preoperative statin therapy (7%).
Conclusions
This study suggests that preoperative statin therapy may have a potential beneficial effect on postoperative mortality after isolated cardiac valve surgery in high-risk cardiovascular patients.
Département d'Anesthésie-Réanimation, Hôpital Bichat, Paris, France
Address reprint requests to Nicolas Allou, MD, Département d'Anesthésie Réanimation, Centre Hospitalier Universitaire Bichat-Claude Bernard, 46 Rue Henri Huchard, 75018 Paris, France
ABSTRACT