Abstract 1106: Incidence of Perioperative Myocardial Infarction and 2-Year Mortality in Patients Who Underwent Noncardiac Vascular Surgery Treated With and Without Statins
Purpose: To investigate the incidence of perioperative myocardial infarction (MI) and of 2-year mortality in patients undergoing noncardiac vascular surgery treated with and without statins.
Methods: Of 577 patients (379 men and 198 women), mean age 74±10 years, undergoing noncardiac vascular surgery, 300 (52%) had carotid endarterectomy, 179 (31%) had lower extremity revascularization, and 98 (17%) had abdominal aortic aneurysm repair. Of the 577 patients, 302 (53%) were treated with statins and 275 (47%) without statins. We investigated the perioperative MI incidence and 2-year mortality in patients treated with and without statins.
Results: The mean age, gender, body mass index, follow-up duration, prevalence of smoking, hypertension, diabetes, prior coronary artery disease, prior stroke or transient ischemic attack, carotid endarterectomy, lower extremity revascularization, and abdominal aortic aneurysm repair, and use of antiplatelet drugs, beta blockers, and anangiotensin-converting enzyme inhibitors or angiotensin receptor blockers were not significantly different between patients treated with and without statins. Dyslipidemia was present in 302 of 302 patients (100%) treated with statins and in 192 of 275 patients (70%) not treated with statins (p<0.0001). Perioperative MI occurred in 18 of 302 patients (6%) treated with statins and in 38 of 275 patients (14%) not treated with statins (p=0.001). Mortality occurred in 18 of 302 patients (6%) treated with statins and in 43 of 275 patients (16%) not treated with statins (p=0.0002). Perioperative MI or mortality occurred in 34 of 302 patients (11%) treated with statins and in 74 of 275 patients (27%) not treated with statins (p<0.0001). Stepwise Cox regression analysis showed that significant independent prognostic factors for perioperative MI or death were use of statins (risk ratio=0.43, p<0.0001), carotid endarterectomy (risk ratio=0.60, p=0.009), use of beta blockers (risk ratio=0.55, p=0.002), and diabetes (risk ratio=1.5, p=0.045).
Conclusions: Patients undergoing noncardiac vascular surgery using statins had a 57% less chance of having perioperative MI or death at 2-year follow-up after controlling other variables.