Abstract 17230: Impact of Preoperative Statin Use on Ascending Aortic Aneurysm Repair Outcomes
Objectives: Statins have potent pleiotropic effects that have been correlated with improved perioperative cardiovascular surgery outcomes. Additionally, statins are protective in murine aortic aneurysm models.
Hypothesis: We hypothesize that statins may improve short-term morbidity and mortality after ascending aortic surgery.
Methods: A total of 2,781 patients who underwent ascending aortic aneurysm repair in a multi-institution database (2004-2015) were stratified by preoperative statin administration. Patients with endocarditis or aortic dissection were excluded. To account for baseline differences, patients were propensity matched (1:1) across 41 preoperative and procedural characteristics, resulting in a well matched cohort of 1682 patients. Patient characteristics and outcomes were analyzed by univariate analysis and logistic regression.
Results: In the total cohort, patients taking statins were older with more comorbid disease, yet had less extensive surgery performed. Composite major morbidity and mortality was significantly lower in patients taking statins (30.2% vs 33.9%, p=0.045). However, in the propensity-matched analysis, patients taking statins had similar outcomes compared to patients not receiving statins including operative mortality (5.6% vs 6.7%, p=0.32) and major morbidity (47.2% vs 46.3%, p=0.72). Postoperative atrial fibrillation (28.3% vs 27.5%, p=0.71) and acute kidney injury (4.8% vs 5.9%, p=0.29) were similar. Furthermore, statin use was not associated with risk-adjusted mortality or major morbidity by logistic regression (all p>0.05). This study has 93% to >99% power to detect a risk reduction in mortality similar to that seen after coronary bypass.
Conclusion: Perioperative statin administration has no apparent clinically significant impact on short-term outcomes after aortic repair. There is insufficient evidence to recommend preoperative statin therapy before ascending aortic repair.
Author Disclosures: R.B. Hawkins: None. J. Mehaffey: None. A. Guo: None. C. Fonner: None. A. Speir: None. J. Rich: None. L. Yarboro: None. R. Ghanta: None. G. Ailawadi: None.
- © 2016 by American Heart Association, Inc.