Abstract 9039: Dose Dependent Effect of Statins on the Incidence of Acute Kidney Injury After Cardiac Surgery
Background: Acute kidney injury (AKI) after heart surgery is associated with increased morbidity and mortality. Whether statins reduce the incidence of postoperative AKI in patients undergoing heart surgery is unknown.
Methods: We included 2104 consecutive patients who underwent heart surgery at the Minneapolis Veterans Affairs (VA) Medical Center. Primary outcome was AKI (defined as absolute increase of >0.5 mg/dL or a relative increase of >25%, in serum creatinine from the pre-operative value to the peak creatinine measured within 5 days after surgery). Propensity scores for statin use were generated and used to adjust for the differences between the statin and no-statin treatment groups. Statin dosages were converted to equivalent dose of Simvastatin and were divided at the median (40 mg) to construct high-dose and low-dose groups.
Results: Mean age was 66±10 years and 1435 (68%) patients were taking statins (638 in high-dose) preoperatively. A total of 539 (26%) patients developed AKI (23% of high-dose group vs. 26% of low-dose group vs. 28% of patients not taking statins; p = 0.03). In multivariable analysis after adjusting for propensity score for statin usage, there was a 25% reduction in AKI incidence among patients treated with high-dose statins, compared to patients not treated with statins pre-operatively (odds ratio 0.76, 95% confidence interval 0.58 to 0.99; p=0.04)). High-dose statin treatment was also associated with decreased perioperative mortality (p=0.002) and length of stay in the intensive care unit (p=0.01).
Conclusion: High-dose statin treatment reduces the incidence of AKI after cardiac surgery.
- © 2010 by American Heart Association, Inc.