Key result
Preoperative statin use was associated with lower 90-day mortality after elective noncardiac surgery compared to nonstatin use (OR 0.74; 95% CI 0.59-0.92; P=0.009).
Why the study?
Statin therapy has pleiotropic effects that improve disease outcomes, but the effect of perioperative statin therapy on postoperative mortality remains controversial.
Does preadmission statin use reduce 90-day mortality in adult patients undergoing planned elective noncardiac surgery?
Cohort (n=33,514)
No
Does preadmission statin use reduce 90-day mortality in adult patients undergoing planned elective noncardiac surgery?
Odds Ratio: 0.74 (95% CI 0.59–0.92)
p-value: p=0.009
Preoperative statin use is associated with significantly lower 90-day mortality and longer overall survival in adult patients undergoing elective noncardiac surgery, with greater benefit seen in high-intensity statin users.
May support preoperative statin consideration; leaves open confirmation by randomized trials before practice change.
OBJECTIVE: The aim of this study was to investigate the association between preadmission statin use and 90-day mortality after planned elective noncardiac surgery in adult patients. SUMMARY BACKGROUND DATA: Statin therapy is known to have pleiotropic effects, which improve the outcomes of various diseases. However, the effect of perioperative statin therapy on postoperative mortality remains controversial. METHODS: This retrospective cohort study analyzed the medical records of adult patients who were admitted to a single tertiary academic hospital for elective noncardiac surgery between January 2012 and December 2018. The primary endpoint was 90-day mortality, which was defined as any mortality within 90 days after surgery. The secondary endpoint was overall survival. RESULTS: After propensity score matching, a total of 33,514 patients (16,757 patients in each group) were included in the analysis. The logistic regression analysis of the propensity score-matched cohort indicated that the odds ratio (OR) of 90-day mortality in the statin group was 26% lower than that of the nonstatin group [OR: 0.74; 95% confidence interval (CI): 0.59 to 0.92; P = 0.009]. The sensitivity analysis indicated that the high-dose intensity statin group had a 61% lower 90-day mortality rate than the nonstatin group (OR: 0.39; 95% CI: 0.18-0.84; P = 0.016). The overall survival time was significantly longer in the statin group than in the nonstatin group after propensity score matching (P < 0.001 by log-rank test). CONCLUSIONS: Preoperative statin use was associated with lower 90-day mortality and longer overall survival for adult patients who underwent elective noncardiac surgery. This association was more evident for high-intensity statin users.
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A 2019 study conducted a cohort in Elective noncardiac surgery (n=33,514). Preoperative statin use vs. Nonstatin use was evaluated on 90-day mortality (OR 0.74, 95% CI 0.59 to 0.92, p=0.009). Preoperative statin use was associated with lower 90-day mortality after elective noncardiac surgery compared to nonstatin use (OR 0.74; 95% CI 0.59-0.92; P=0.009).
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