Key result
Preoperative statin use is linked to ~49% less cognitive dysfunction and fewer clinical strokes.
Why the study?
Statins are neuroprotective in experimental cerebral injury models, but their effect on neurological injury after asymptomatic carotid endarterectomy was unclear.
Does preoperative statin use reduce perioperative neurological injury in patients with asymptomatic carotid stenosis undergoing elective carotid endarterectomy?
Observational (n=328)
Does preoperative statin use reduce perioperative neurological injury in patients with asymptomatic carotid stenosis undergoing elective carotid endarterectomy?
Preoperative statin use in patients undergoing asymptomatic carotid endarterectomy is associated with a significantly lower risk of perioperative clinical stroke and cognitive dysfunction.
May support preoperative statin use in asymptomatic carotid stenosis; leaves open need for RCTs to confirm causality.
BACKGROUND AND PURPOSE: Statins are neuroprotective in a variety of experimental models of cerebral injury. We sought to determine whether patients taking statins before asymptomatic carotid endarterectomy exhibit a lower incidence of neurological injury (clinical stroke and cognitive dysfunction). METHODS: A total of 328 patients with asymptomatic carotid stenosis scheduled for elective carotid endarterectomy consented to participate in this observational study of perioperative neurological injury. RESULTS: Patients taking statins had a lower incidence of clinical stroke (0.0% vs 3.1%; P=0.02) and cognitive dysfunction (11.0% vs 20.2%; P=0.03). In a multivariate regression model, statin use was significantly associated with decreased odds of cognitive dysfunction (odds ratio, 0.51 [95% CI, 0.27-0.96]; P=0.04). CONCLUSIONS: Preoperative statin use was associated with less neurological injury after asymptomatic carotid endarterectomy. These observations suggest that it may be possible to further reduce the perioperative morbidity of carotid endarterectomy. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00597883.
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Heyer et al. (2013) conducted an observational in Asymptomatic carotid stenosis (n=328). Statins vs. No statin use was evaluated on Cognitive dysfunction (OR 0.51, 95% CI 0.27-0.96, p=0.04). Preoperative statin use was associated with decreased odds of cognitive dysfunction (OR 0.51; 95% CI 0.27-0.96; P=0.04) and a lower incidence of clinical stroke (0.0% vs 3.1%).
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