Author/Editor		Pintar, Tatjana
Title		Vpliv statinov na pooperativne zaplete pri bolnikih po kirurški revaskularizaciji venčnih arterij
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2005
Volume		str. 32
Language		slo
Abstract		Background Statin therapy in non-surgical patient populations is associated with a significant reduction in adverse cardiovascular events, including death, myocardial infarction (MI) and stroke. Recently, statin therapy was shown to be assotiated with a reduced incidence of postoperative mortality in patients undergoing major noncardiac vascular surgery. We investigated the influence of preoperative statin therapy on adverse outcomes following primary CABG surgery. Methods and Results A retrospective cohort study of patients undergoing primary CABG surgery with cardiopulmonary bypass (n = 1663) between January 1, 2000 and December 31, 2001 at the Texas Heart Institute was performed. Patients were classified into 2 groups: patients receiving preoperative statin therapy (n = 943) and patients not receiving preoperative anti-hyperlipidemic therapy (n = 720). To determine if preoperative statin therapy was independently associated with a reduction in the risk of adverse postoperative outcomes, multivariate, stepwise logistic regression was performed controlling for patient demographics, medical history and preoperative medications. Multivariate logistic regression analysis demonstrated that preoperative statin therapy was independently associated with a significant reduction (=50 %) in the risk of 30-day all cause mortality (3,75 vs. 1,80 %; p < 0,05). The adjusted odds ratio for early mortality in patients receiving preoperative statin therapy compared to patients not receiving anti-hyperlipidemic agents was 0.53 (95% CI = 0.28 to 0.99). Statin therapy was not independently associated with a reduced risk of postoperative MI, cardiac arrhythmias, stroke, or renal dysfunction. In an attempt to further control for selection bias related to the choice of therapy, multivariate analysis of a propensity-matched cohort of 1362 patients revealed that preoperative statin therapy was independently associated.
Descriptors		CORONARY DISEASE CARDIOPULMONARY BYPASS HYDROXYMETHYLGLUTARYL COA REDUCTASES HYPERCHOLESTEROLEMIA ANTILIPEMIC AGENTS CEREBRAL INFARCTION KIDNEY FAILURE MYOCARDIAL INFARCTION POSTOPERATIVE COMPLICATIONS ARRHYTHMIA ELECTROCARDIOGRAPHY MULTIVARIATE ANALYSIS COHORT STUDIES RETROSPECTIVE STUDIES