Key result
Long-term preoperative use of atorvastatin did not significantly increase the incidence of acute kidney injury on postoperative day 2 compared to rosuvastatin (7.4% vs 6.5%; OR 1.182; p=0.794).
Why the study?
Statins may help prevent post-cardiac surgery acute kidney injury through pleiotropic effects, but studies on their efficacy and safety show varied results.
Does long-term preoperative use of atorvastatin or rosuvastatin increase the incidence of postoperative acute kidney injury in adult patients undergoing CABG?
Cohort (n=958)
Does long-term preoperative use of atorvastatin or rosuvastatin increase the incidence of postoperative acute kidney injury in adult patients undergoing CABG?
Odds Ratio: 1.182 (95% CI 0.411–3.397)
Absolute Event Rate: 7.4% vs 6.5%
p-value: p=0.794
Long-term preoperative use of atorvastatin or rosuvastatin is safe and does not increase the risk of postoperative acute kidney injury in patients undergoing CABG.
Background: Acute kidney injury (AKI) is among the expected complications of cardiac surgery. Statins with pleiotropic anti-inflammatory and antioxidant effects may be effective in the prevention of AKI. However, the results of studies on the efficacy and safety of statins are varied and require further study. Methods: We conducted a retrospective cohort study to evaluate long-term preoperative intake of atorvastatin and rosuvastatin on the incidence of AKI, based on the “Kidney Disease: Improving Global Outcomes” (KDIGO) criteria in the early postoperative period after coronary artery bypass graft surgery (CABG). We performed propensity score matching to compare the findings in our study groups. The incidence of AKI was assessed on day 2 and day 4 after the surgery. Results: The analysis included 958 patients after CABG. After 1:1 individual matching, based on propensity score, the incidence of AKI was comparable both on day 2 after the surgery (7.4%) between the atorvastatin group and rosuvastatin group (6.5%) (OR: 1.182; 95%Cl 0.411–3.397; p = 0.794), and on postoperative day 4 between the atorvastatin group (3.7%) and the rosuvastatin group (4.6%) (OR: 0.723, 95%Cl 0.187–2.792; p = 0.739). Additionally, there were no statistically significant differences in terms of incidence of AKI after 1:1 individual matching, based on propensity score, between the rosuvastatin group and the control group both on postoperative day 2 (OR: 0.692; 95%Cl 0.252–1.899; p = 0.611) and day 4 (OR: 1.245; 95%Cl 0.525–2.953; p = 0.619); as well as between the atorvastatin group and the control group both on postoperative day 2 (OR: 0.549; 95%Cl 0.208–1.453; p = 0.240) and day 4 (OR: 0.580; 95%Cl 0.135–2.501; p = 0.497). Conclusion: Long-term statin use before CABG did not increase the incidence of postoperative AKI. Further, we revealed no difference in the incidence of post-CABG AKI between the atorvastatin and rosuvastatin groups.
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Shvartz et al. (2022) conducted a cohort in Acute kidney injury after CABG (n=958). Long-term preoperative atorvastatin or rosuvastatin vs. Control group or alternative statin was evaluated on Incidence of acute kidney injury (AKI) on postoperative day 2 (OR 1.182, 95% CI 0.411-3.397, p=0.794). Long-term preoperative use of atorvastatin did not significantly increase the incidence of acute kidney injury on postoperative day 2 compared to rosuvastatin (7.4% vs 6.5%; OR 1.182; p=0.794).
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