Beyond cholesterol reduction, statins have multiple beneficial influences on vascular
endothelial function, atherosclerotic plaque stability, inflammation, and thrombosis.
These favorable pleiotropic effects may be the basis for their perioperative risk
reduction in cardiothoracic and vascular procedures. The published evidence suggests
that statins offer significant outcome benefits throughout perioperative practice.
Because statin therapy significantly reduces the perioperative risk for patients undergoing
cardiovascular procedures, they already are recommended in published guidelines. Beyond
cardiac risk reduction, statin therapy also may protect the brain and the kidney in
the perioperative setting, both in cardiac and vascular surgery. The pleiotropic effects
of statins also appear to have therapeutic roles in the progression of valve disease,
sepsis, and venous thrombosis. Further trials are required to provide data to drive
their safe and comprehensive perioperative application for optimal patient outcome
both in the short term and the long term. Because there are multiple randomized trials
currently in progress throughout perioperative medicine, it is very likely that the
indications for statins will be expanded significantly.
Key Words
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Article info
Publication history
Published online: August 12, 2010
Footnotes
John G.T. Augoustides, MD, FASE, FAHA
Section Editor
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
