Preoperative Statins Found to Reduce AF and Length of Stay But Not Mortality

In a systematic review published in the Cochrane Library investigators at the University of Cologne in Germany analyzed data from 11 trials that tested the effects of preoperative statins in 984 patients undergoing heart surgery Preoperative administration of statins reduced the risk of developing atrial fibrillation AF and shortened the length of stay on the ICU and in the hospital but did not have a statistically significant effect on mortality or MI

Postoperative AF OR 040 CI 029 to 055 plt001
Shortterm mortality OR 098 CI 014 to 710 p098
ICU length of stay WMD weighted mean difference 339 hours CI 577 to 101
Hospital length of stay WMD 048 days CI 085 to 011
MI OR 052 CI 02 to 130
The authors noted that the studies mostly contained patients undergoing myocardial revascularization so the findings may not apply to other cardiac procedures

To get a clearer picture of the potential benefits of taking statins before a heart operation we need to have more clinical trials and find out whether clinical outcomes can be further improved if patients use special statin dosing regimens shortly before a heart procedure said lead researcher Oliver Liakopoulos in a Cochrane Library press release
Here is the press release from the Cochrane Library

PreOperative Statins Can Help Patients Who Undergo Heart Surgery

Preoperative statin therapy can reduce the chance of postoperative atrial fibrillation and shortens the stay on the intensive care unit ICU and in the hospital in patients who undergo cardiac surgery according to a new systematic review by Cochrane researchers However statin pretreatment had no influence on the risk of dying stroke heart attack or kidney failure around the time of the operation

Statins are known to help lower the levels of lipids in peoples blood This in turn reduces the risk of patients with coronary heart disease dying Before this study it was unclear whether patients who are about to undergo heart surgery would also benefit if they took statins before the operation

A team of researchers based at the University of Cologne in Germany analysed data found in 11 randomized controlled studies These studies included a total of 984 participants who were undergoing different forms of heart surgery

They found that giving statins before surgery reduced the incidence of postoperative atrial fibrillation suggesting a beneficial effect for patients with a statin treatment when compared to patients without a statin therapy In addition they discovered that patients who had statins before the operation tended to leave the ICU about threeanda half hours earlier and left hospital about half a day earlier There was however no significant reduction in the proportion of people who had a heart attack or kidney failure subsequently Furthermore statins had no effect on the number of people who died or had a stroke soon after the operation

The researchers point to one limitation of their findings Since the data we analysed had come mainly from patients having coronary artery bypass operations the results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery says lead researcher Oliver J Liakopoulos who works in the Department of Cardiothoracic Surgery at the University of Colognes Heart Centre

At the same time the researchers emphasise the need for more data To get a clearer picture of the potential benefits of taking statins before a heart operation we need to have more clinical trials and find out whether clinical outcomes can be further improved if patients use special statin dosing regimens shortly before a heart procedure says Liakopoulos

Full citation Liakopoulos OJ Kuhn EW Slottosch I Wassmer GWahlers T Preoperative statin therapy for patients undergoing cardiac surgery Cochrane Database of Systematic Reviews 2012 Issue 4 Art No CD008493 DOI 10100214651858CD008493pub2

Date : 19 Apr, 2012
Reference : http://www.forbes.com/sites/larryhusten/2012/04/18/preoperative-statins-found-to-reduce-af-and-lengt

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