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Statins for surgical patients.

Trevor M Williams¹, Alden H Harken

¹Department of Surgery, University of California, San Francisco-East Bay, Oakland, CA, USA. trevor.williams@mail.mcgill.ca

Annals of Surgery

|December 25, 2007

Summary

Perioperative statin treatment shows benefits for reducing surgical complications. Evidence suggests statins should be continued in surgical patients due to their protective effects and to avoid a rebound effect.

Area of Science:

Cardiovascular Medicine
Pharmacology
Surgical Risk Management

Background:

Vascular, cerebrovascular, and cardiovascular complications frequently occur in surgical patients.
While beta-blockers are established for perioperative cardiac risk reduction, statins offer a strong pathophysiologic basis for prophylaxis.

Purpose of the Study:

To evaluate perioperative statin treatment efficacy.
To explore the pleiotropic effects of statins in surgical contexts.
To propose a rational strategy for perioperative risk reduction using statins.

Main Methods:

Conducted a PubMed search using "surgery" and "hydroxymethylglutaryl-CoA reductase inhibitors" (statins).
Included studies on statin treatment outcomes in surgical series, excluding transplant surgery and studies without relevant outcomes.

Related Experiment Videos

Reviewed medical literature on statin use and cardiac outcomes, incorporating basic science investigations on mechanisms of perioperative risk reduction.

Main Results:

Delineated the pharmacology and pleiotropic effects of statins.
Identified multiple beneficial outcomes associated with perioperative statin use.
Observed apparent benefits of perioperative statins, though clinical recommendations are limited by the availability of only one clinical trial.

Conclusions:

Evidence supports a rebound effect upon statin discontinuation.
Statin treatment should be initiated and maintained in surgical patients.
Current literature indicates statins provide preoperative protection.