Key result
Perioperative statin therapy in patients undergoing on-pump cardiac surgery did not significantly affect overall hemodynamic parameters or clinical outcomes, though it was associated with a lower Systemic Vascular Resistance Index (882 vs 1050 dyn·s/cm5/m2, p=0.022).
Why the study?
Does perioperative statin therapy improve hemodynamic parameters and clinical outcomes in patients undergoing on-pump cardiac surgery?
Cohort (n=478)
No
Does perioperative statin therapy improve hemodynamic parameters and clinical outcomes in patients undergoing on-pump cardiac surgery?
Should not change perioperative statin practice in on-pump surgery; hypothesis-generating for isolated SVRI effects in prospective trials.
BACKGROUND: Peri-operative statin therapy in cardiac surgery cases is reported to reduce the rate of mortality, stroke, postoperative atrial fibrillation, and systemic inflammation. Systemic inflammation could affect the hemodynamic parameters and stability. We set out to study the effect of statin therapy on perioperative hemodynamic parameters and its clinical outcome. METHODS: In a single center study from 2006 to 2007, peri-operative hemodynamic parameters of 478 patients, who underwent cardiac surgery with cardiopulmonary bypass, were measured. Patients were divided into those who received perioperative statin therapy (n = 276; statin group) and those who did not receive statin therapy (n = 202; no-statin group). The two groups were compared together using Kolmogorov-Smirnov-Test, Fisher's-Exact-Test, and Student's-T-test. A p value < 0.05 was considered as significant. RESULTS: There was no significant difference in the preoperative risk factors. Onset of postoperative atrial fibrillation was not affected by statin therapy. Extended hemodynamic measurements revealed no significant difference between the two groups, apart from Systemic Vascular Resistance Index (SVRI). The no-statin group had a significantly higher SVRI (882 ± 206 vs. 1050 ± 501 dyn s/cm5/m2, p = 0.022). Inotropic support was the same in both groups and no significant difference in the mortality rate was noticed. Also, hemodynamic parameters were not affected by different types and doses of statins. CONCLUSIONS: Perioperative statin therapy for patients undergoing on-pump coronary bypass grafting or valvular surgery, does not affect the hemodynamic parameters and its clinical outcome.
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Hinz et al. (2012) conducted a cohort in On-pump cardiac surgery (n=478). Perioperative statin therapy vs. No statin therapy was evaluated on Systemic Vascular Resistance Index (SVRI) (p=0.022). Perioperative statin therapy in patients undergoing on-pump cardiac surgery did not significantly affect overall hemodynamic parameters or clinical outcomes, though it was associated with a lower Systemic Vascular Resistance Index (882 vs 1050 dyn·s/cm5/m2, p=0.022).
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