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Perioperative statin use: an update
Phillip L Kalarickal1, Charles J Fox, Jeffrey Y Tsai
1Department of Anesthesiology, Tulane University Medical Center, 1430 Tulane Avenue, SL-4, New Orleans, LA 70112, USA.
Insights
Statins, or HMG CoA reductase inhibitors, effectively lower cholesterol and improve cardiovascular outcomes. This review examines their benefits in the perioperative period, including pharmacology and evidence.
Area of Science:
- Cardiology
- Pharmacology
- Perioperative Medicine
Background:
- HMG CoA reductase inhibitors (statins) are established for reducing serum cholesterol.
- Statins have demonstrated efficacy in reducing cardiovascular morbidity and mortality.
- Evidence suggests statins improve postoperative outcomes in patients using them perioperatively.
Purpose of the Study:
- To review the pharmacology of statins.
- To summarize the mechanisms behind statins' beneficial effects.
- To provide an overview of evidence for perioperative statin use.
Main Methods:
- Literature review of studies on statin pharmacology.
- Analysis of mechanisms of action for statins.
- Synthesis of evidence regarding perioperative statin use in diverse patient populations and surgeries.
Main Results:
- Statins exhibit pleiotropic effects beyond lipid-lowering.
- Mechanisms include anti-inflammatory, antioxidant, and plaque-stabilizing properties.
- Evidence supports statin use in the perioperative period, though study limitations exist.
Conclusions:
- Statins offer significant cardiovascular benefits and perioperative advantages.
- Understanding statin pharmacology and mechanisms is crucial for optimizing patient care.
- Further research may clarify optimal use in varied surgical and patient contexts.
Abstract:
HMG CoA reductase inhibitors (statins) are a proven modality to reduce serum cholesterol and have been shown to reduce morbidity and mortality in cardiovascular patients. Statins have also demonstrated improvements in postoperative outcomes among patients taking them in the perioperative period. Many of the studies are limited to select patient populations and/or select surgeries. This review will give an overview of the pharmacology of statins, summarize the mechanisms of the beneficial effects of statins, and provide an overview of evidence in the use of statins in the perioperative period.
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