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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Statins and coronary artery bypass graft surgery: preoperative and postoperative efficacy and safety

Alexander Kulik1, Marc Ruel

  • 1Vascular and Endovascular Surgery Fellow, Arizona Heart Institute, 2632 North 20th Street, Phoenix, Arizona, 85006, USA. alex_kulik@yahoo.com

Expert Opinion on Drug Safety
|August 14, 2009
PubMed

Insights

Statins significantly improve outcomes for patients undergoing coronary artery bypass graft (CABG) surgery, reducing mortality and complications. These cholesterol-lowering drugs are safe and beneficial both before and after CABG surgery.

Area of Science:

  • Cardiology
  • Pharmacology
  • Surgical Outcomes

Background:

  • Statins are proven to reduce cardiovascular events in native coronary artery disease.
  • Statin use is underutilized in patients undergoing coronary artery bypass graft (CABG) surgery.
  • Concerns exist regarding the perioperative safety of statins in CABG patients.

Purpose of the Study:

  • To systematically review the safety and efficacy of statin therapy in patients undergoing coronary surgical revascularization.
  • Evaluate the impact of statins administered before and after CABG surgery.

Main Methods:

  • Systematic review of articles from the Medline database.
  • Literature search conducted from 1987 to January 2009.

Main Results:

  • Preoperative statins reduce perioperative mortality, stroke, and atrial fibrillation after CABG.
  • Statins decrease the systemic inflammatory response to cardiopulmonary bypass.
  • Postoperative statins inhibit graft disease and atherosclerosis progression, reducing cardiovascular events and improving mortality.
  • Adverse effects of perioperative statins are rare.

Conclusions:

  • Statins demonstrably improve outcomes for CABG patients, with benefits outweighing risks.
  • Statin therapy should be initiated before CABG surgery in most patients.
  • Optimal postoperative statin regimens require further investigation.
Abstract

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