Abstract 3345: Impact of Preoperative Statin Therapy on Postoperative Major Adverse Cardiac Events Following Coronary Artery Bypass Surgery
Background–Statin therapy has been clearly shown to reduce the risk of mortality and coronary events in patients with coronary artery disease. Whether these beneficial effects similarly exist in patients with preoperative statin therapy undergoing coronary artery bypass grafting (CABG) is still debatable.
Objectives–We sought to determine, whether preoperative statin therapy may decrease postoperative in-hospital mortality and major adverese cardiac events (MACE) in patients following CABG.
Methods–Prospectively recorded clinical data of 3346 consecutive patients with isolated first-time CABG between 01/2000 and 03/2006 were retrospectively analyzed for all-cause in-hospital death and MACE. Out of these patients, 167 had preoperative statin-untreated hyperlipidemia (group 1) and 2592 had statin-treated hyperlipidemia (group 2), whereas 587 patients without hyperlipidemia were excluded. A propensity analysis was performed to match (n:m) the two groups of patients with statin-untreated and statin-treated hyperlipidemia. Logistic regression models were generated to determine a possible relationship between preoperative statin therapy and postoperative in-hospital death and MACE.
Results–In-hospital MACE was identified in 12.2% in group 1 and 5.7% in group 2 (odds ratio [OR], 0.42, 95% confidence interval [CI], 0.25–0.71; P=0.001). Overall in-hospital mortality was 2.4% in group 1 and 2.6% in group 2 (OR, 1.10, CI, 0.38–3.58; P=1.00). Risk-adjusted multivariate logistic regression analysis revealed preoperative statin therapy to be independently associated with a reduction of in-hospital MACE (odds ratio [OR], 0.42, 95% confidence interval [CI], 0.26–0.69, P=0.0007). After propensity score matching, conditional regression analysis confirmed preoperative statin therapy to be significantly related with reduced in-hospital MACE (OR, 0.39, 95% CI, 0.23–0.68, P=0.0007) but not with in-hospital mortality (OR, 1.1, 95% CI, 0.34–3.57, P=0.86) following CABG.
Conclusions–Preoperative statin therapy before isolated first-time CABG surgery is clearly associated with a significant reduction of postoperative in-hospital MACE.