Key result
Preoperative statin therapy was associated with a 44% reduction in overall postoperative mortality (2.2% vs. 3.2%; P=0.0001) across cardiac, vascular, and noncardiac surgeries.
Why the study?
Does preoperative statin therapy reduce postoperative mortality and morbidity in patients undergoing cardiac, vascular, or noncardiovascular surgery?
Meta-Analysis (n=223,010)
Does preoperative statin therapy reduce postoperative mortality and morbidity in patients undergoing cardiac, vascular, or noncardiovascular surgery?
Effect estimate: 44% reduction
Absolute Event Rate: 2.2% vs 3.2%
p-value: p=0.0001
Preoperative statin therapy is associated with a significant reduction in postoperative mortality across cardiac, vascular, and noncardiac surgeries.
Statin use may reduce postoperative mortality; leaves open whether RCTs are needed before changing practice.
Statin therapy is well established for prevention of cardiovascular disease. Statins may also reduce postoperative mortality and morbidity via a pleiotropic (non-lipid-lowering) effect. The authors conducted a meta-analysis to determine the influence of statin treatment on adverse postoperative outcomes in patients undergoing cardiac, vascular, or noncardiovascular surgery. Two independent authors abstracted data from 12 retrospective and 3 prospective trials (n = 223,010 patients). A meta-analysis was performed to evaluate the overall effect of preoperative statin therapy on postoperative outcomes. Preoperative statin therapy was associated with 38% and 59% reduction in the risk of mortality after cardiac (1.9% vs. 3.1%; P = 0.0001) and vascular (1.7% vs. 6.1%; P = 0.0001) surgery, respectively. When including noncardiac surgery, a 44% reduction in mortality (2.2% vs. 3.2%; P = 0.0001) was observed. Preoperative statin therapy may reduce postoperative mortality in patients undergoing surgical procedures. However, the statin associated effects on postoperative cardiovascular morbidity are too variable to draw any conclusion.
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Hindler et al. (2006) conducted a meta-analysis in Cardiac, vascular, or noncardiovascular surgery (n=223,010). Preoperative statin therapy vs. No preoperative statin therapy was evaluated on Postoperative mortality (44% reduction, p=0.0001). Preoperative statin therapy was associated with a 44% reduction in overall postoperative mortality (2.2% vs. 3.2%; P=0.0001) across cardiac, vascular, and noncardiac surgeries.
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