Key result
Preoperative moderate-dose statin was significantly associated with a reduced incidence of postoperative acute kidney injury (28.9% vs 43.0%; OR 0.54; 95% CI 0.38-0.77; p<0.001).
Why the study?
The impact of preoperative statin use on postoperative acute kidney injury remains uncertain.
Does preoperative moderate-dose statin therapy reduce postoperative acute kidney injury in patients undergoing cardiac surgery?
Cohort (n=1,581)
Does preoperative moderate-dose statin therapy reduce postoperative acute kidney injury in patients undergoing cardiac surgery?
Odds Ratio: 0.54 (95% CI 0.38–0.77)
Absolute Event Rate: 28.9% vs 43%
p-value: p=<0.001
Preoperative moderate-dose statin therapy, particularly when administered for 7 days or longer, is associated with a significantly reduced risk of postoperative acute kidney injury in patients undergoing cardiac surgery.
Preoperative statin use was associated with lower postoperative AKI risk; leaves open whether to initiate therapy before cardiac surgery.
Background The impact of preoperative statin use on postoperative acute kidney injury (AKI) is uncertain. We aimed to examine the association of statin therapy before cardiac surgery with postoperative AKI.Methods The retrospective cohort study consisted of 1581 patients undergoing cardiac surgery. Postoperative AKI were identified by the modified KDIGO definition. Propensity-score matching was employed to control for selection bias, and logistic regression was used to control for confounders. Subgroup and interaction analyses were performed to evaluate the robustness of the findings.Results The overall incidence of postoperative AKI and severe AKI were 42.19% and 12.27%, respectively. Preoperative moderate-dose statin was significantly associated with a reduced incidence of postoperative AKI (28.9% vs 43.0%, OR (95%CI): 0.54 (0.38, 0.77), p < 0.001) and severe AKI (6.9% vs 13.7%, OR (95%CI): 0.46 (0.26, 0.83), p = 0.009). The beneficial effect on postoperative AKI persisted after adjusting for major confounding factors (OR (95%CI): 0.47 (0.34, 0.66)). Decreased risk of postoperative AKI was observed in patients with preoperative statin duration of 7 ∼ 14 days (OR (95%CI): 0.41 (0.25, 0.65)) and over 14 days (OR (95%CI): 0.43 (0.28, 0.65)), but not in those with preoperative statin duration of <7 days. Similar favorable effects were noted in most subgroup patients, except for those with high-risk factors such as diabetes mellitus, previous congestive cardiac failure, arrhythmia, preoperative ACEI/ARB, aortic cross-clamping or IABP.Conclusion Preoperative moderate-dose statin was significantly related to a decreased risk of postoperative AKI, especially in patients who received statins for a longer duration. Further large-scale multicenter randomized controlled trials are needed to ascertain the impact of statin dose, duration, and timing on postoperative AKI in cardiac surgery patients.
No takes yet. Share an insight, caveat, or question.
Jiang et al. (2023) conducted a cohort in Postoperative acute kidney injury (n=1,581). Preoperative moderate-dose statin vs. No preoperative moderate-dose statin was evaluated on postoperative acute kidney injury (AKI) (OR 0.54, 95% CI 0.38-0.77, p=<0.001). Preoperative moderate-dose statin was significantly associated with a reduced incidence of postoperative acute kidney injury (28.9% vs 43.0%; OR 0.54; 95% CI 0.38-0.77; p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: