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Statin therapy improves outcomes after valvular heart surgery

Lynn M Fedoruk1, Hongkun Wang, Mark R Conaway

  • 1Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia 22908-0679, USA. lfedoruk@telus.net

The Annals of Thoracic Surgery
|April 30, 2008
PubMed

Insights

Statin therapy improved outcomes for patients undergoing cardiac valve surgery, reducing mortality and complications. This suggests statins offer benefits beyond lipid reduction in cardiac patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • 3-hydroxy-3-methylglutaryl coenzyme A (HMG Co-A) reductase inhibitors (statins) are known to benefit patients undergoing coronary artery bypass grafting.
  • The impact of statin therapy on outcomes in patients undergoing cardiac valve operations was investigated.

Purpose of the Study:

  • To evaluate the association between statin use and postoperative outcomes in patients undergoing cardiac valve surgery.
  • To compare morbidity and mortality rates between patients who received statins and those who did not.

Main Methods:

  • A retrospective study of 447 consecutive patients undergoing valve operations between July 2004 and February 2006.
  • Comparison of preoperative risk factors and outcome data between 203 patients on statins and 244 patients not on statins.
  • Primary outcomes assessed included 30-day mortality, renal failure, and postoperative stroke.

Main Results:

  • The statin group, despite having more comorbidities and risk factors (e.g., diabetes, previous stroke, dyslipidemia), demonstrated better outcomes.
  • Unadjusted analysis showed a trend favoring the statin group for the composite endpoint of death/stroke/renal failure (OR 1.90, p=0.068).
  • Adjusted univariate analysis revealed a significant benefit of statin therapy for the composite endpoint (e.g., diabetes OR 2.29, p=0.024; stroke OR 2.15, p=0.034).

Conclusions:

  • Statin therapy in patients undergoing cardiac valve procedures is associated with reduced postoperative morbidity and mortality.
  • The beneficial mechanism of statins in this context may be independent of their lipid-lowering effects.
  • Further investigation via a prospective, randomized-controlled trial is recommended to confirm these findings.
Abstract

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