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Renoprotective effect of preoperative statins in coronary artery bypass grafting
Minoru Tabata1, Zain Khalpey, Paul A Pirundini
1Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA. mtabata@post.harvard.edu
Insights
Preoperative statin use may protect kidney function after coronary artery bypass grafting (CABG). This study found a lower incidence of new renal insufficiency in patients taking statins before surgery.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- The impact of preoperative statin therapy on kidney outcomes following coronary artery bypass grafting (CABG) is not well established.
- Renal insufficiency is a significant complication after cardiac surgery.
Purpose of the Study:
- To investigate the association between preoperative statin use and the incidence of new renal insufficiency in patients undergoing isolated CABG.
Main Methods:
- Retrospective review of 1,802 patients undergoing isolated CABG.
- Construction of two propensity score-matched cohorts (641 patients each) for statin and non-statin groups.
- Multivariate logistic regression analysis to assess the association between preoperative statin use and new renal insufficiency.
Main Results:
- In the matched analysis, the statin group showed a significantly lower incidence of new renal insufficiency (1.6% vs. 3.9%, OR 0.39, p=0.01).
- Multivariate analysis of all patients confirmed that preoperative statin use was significantly associated with a lower incidence of new postoperative renal insufficiency (OR 0.54, p=0.047).
Conclusions:
- Preoperative statin use appears to have a renoprotective effect in patients undergoing coronary artery bypass grafting.
- Further research may confirm statins as a strategy to reduce postoperative renal complications in cardiac surgery patients.
Abstract:
The renoprotective effect of preoperative statin use in coronary artery bypass grafting remains poorly defined. A retrospective review of 1,802 consecutive patients who underwent isolated coronary artery bypass grafting from January 2002 to October 2005 was performed. Of those, 1,039 patients were receiving statins preoperatively, and 763 patients were not. Two propensity score-matched cohorts each of 641 patients (statin and nonstatin groups) were constructed. Multivariate logistic regression analyses for matched patients and all patients were performed to investigate whether preoperative statin use was associated with the incidence of new renal insufficiency. In a matched analysis, the statin group had a lower incidence of new renal insufficiency than the nonstatin group (1.6% vs 3.9%, odds ratio 0.39, 95% confidential interval 0.18 to 0.82, p = 0.01). Multivariate logistic regression analysis including all patients also showed that preoperative statin use (odds ratio 0.54, 95% confidence interval 0.30 to 0.99, p = 0.047) was significantly associated with low incidence of new postoperative renal insufficiency. In conclusion, preoperative statin use may be renoprotective after coronary artery bypass grafting.
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