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(Circulation. 2008;118:1777-1778.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Impact of Statin Use on Outcomes After Coronary Artery Bypass Graft Surgery

 
Strong evidence is available to support the use of statins to reduce the risk of recurrent cardiovascular events in patients with native coronary artery disease; however, less is known about the benefits of statins after coronary artery bypass grafting (CABG). Previous randomized controlled trials investigating cholesterol reduction after CABG enrolled relatively healthy male patients <65 years of age who had undergone surgery several years earlier; however, CABG patients in the current era are older, have more coexisting conditions, and are increasingly likely to be women. We sought to clarify the role of statin therapy in this context and conducted a retrospective cohort study of 7503 CABG patients 65 years old who had and had not received statins within 1 month of hospital discharge after CABG. Our primary outcomes were all-cause mortality and freedom from major adverse cardiovascular events. Multivariable and propensity score–adjusted analysis demonstrated that statin use within 1 month of CABG discharge independently reduced the risk of all-cause mortality (adjusted hazard ratio 0.82, 95% confidence interval 0.72 to 0.94) and major adverse cardiovascular events (adjusted hazard ratio 0.89, 95% confidence interval 0.81 to 0.98) compared with nonuse. Thus, early statin therapy independently improved postoperative outcomes, and these results confirm those of earlier studies within a contemporary surgical population. Our findings endorse the view that essentially all patients should be prescribed long-term statin therapy after CABG. See p 1785.

	Morphological and Physiological Predictors of Fetal Aortic Coarctation

 
Undiagnosed coarctation can cause neonatal circulatory collapse and death, but morbidity is reduced by antenatal detection and appropriate perinatal management. . . . [Full Text of this Article]

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