Key result
Preoperative rosuvastatin reload reduced the incidence of major adverse cardiovascular and cerebrovascular events by 52% at 6 months after noncardiac emergency surgery (p=0.03).
Why the study?
Does preoperative rosuvastatin reduce myocardial necrosis and MACCE in patients with stable coronary artery disease undergoing emergency noncardiac surgery?
RCT (n=550)
Does preoperative rosuvastatin reduce myocardial necrosis and MACCE in patients with stable coronary artery disease undergoing emergency noncardiac surgery?
Effect estimate: 52% reduction
p-value: p=0.03
Preoperative rosuvastatin reload therapy significantly reduces perioperative myocardial infarction and MACCE in patients with stable CAD undergoing emergency noncardiac surgery.
Supports preoperative rosuvastatin reload before emergency noncardiac surgery in stable CAD; extends statin evidence to this high-risk perioperative population.
OBJECTIVES: We explored whether preoperative rosuvastatin could protect the cardiac health of patients with coronary artery disease undergoing emergency, noncardiac surgery. METHODS: We randomized 550 noncardiac emergency surgery patients with stable coronary artery disease on long-term statin therapy to treatment with and without preoperative rosuvastatin. All patients received rosuvastatin after surgery. We evaluated the incidence of myocardial necrosis and major adverse cardiovascular and cerebrovascular events (MACCE) 30 days and 6 months after surgery. RESULTS: Creatinine kinase-myocardial band (CK-MB) isoform elevations occurred less frequently 12 and 24 h after noncardiac emergency surgery in the experimental group than in the control group (p = 0.029). After surgery, the incidence of MACCE was also lower in the experimental group than in the control group (p = 0.019). The difference was mainly due to the incidence of perioperative myocardial infarction (p = 0.029). Multivariable analysis found that rosuvastatin reload reduced the incidence of MACCE 52% 6 months after surgery (p = 0.03). CONCLUSIONS: Preoperative rosuvastatin reload therapy decreases the incidence of myocardial necrosis and MACCE after noncardiac emergency surgery in patients with stable coronary artery disease on long-term statin therapy.
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Xia et al. (2015) conducted an RCT in Stable coronary artery disease undergoing noncardiac emergency surgery (n=550). Preoperative rosuvastatin vs. No preoperative rosuvastatin was evaluated on Incidence of myocardial necrosis and major adverse cardiovascular and cerebrovascular events (MACCE) 30 days and 6 months after surgery (52% reduction, p=0.03). Preoperative rosuvastatin reload reduced the incidence of major adverse cardiovascular and cerebrovascular events by 52% at 6 months after noncardiac emergency surgery (p=0.03).
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