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Preoperative rosuvastatin protects patients with coronary artery disease undergoing noncardiac surgery

Jinggang Xia1, Yang Qu, Chunlin Yin

  • 1Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, PR China.

Cardiology
|April 3, 2015
PubMed

Insights

Preoperative rosuvastatin therapy protected cardiac health in patients with coronary artery disease undergoing emergency surgery. This treatment reduced myocardial necrosis and major adverse cardiovascular and cerebrovascular events (MACCE).

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Patients with coronary artery disease (CAD) undergoing emergency noncardiac surgery face elevated cardiovascular risks.
  • Long-term statin therapy is common in CAD patients but its perioperative role in emergency settings requires further investigation.

Purpose of the Study:

  • To determine if preoperative rosuvastatin administration could protect cardiac health in patients with CAD undergoing emergency noncardiac surgery.

Main Methods:

  • A randomized controlled trial involving 550 patients with stable CAD on long-term statin therapy undergoing emergency noncardiac surgery.
  • Patients were randomized to receive preoperative rosuvastatin or a placebo (control group).
  • All patients received rosuvastatin post-surgery; outcomes assessed included myocardial necrosis and major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days and 6 months.

Main Results:

  • Lower incidence of creatinine kinase-myocardial band (CK-MB) elevations at 12 and 24 hours post-surgery in the rosuvastatin group (p = 0.029).
  • Significantly reduced incidence of MACCE in the rosuvastatin group compared to the control group (p = 0.019), primarily driven by a decrease in perioperative myocardial infarction (p = 0.029).
  • Multivariable analysis indicated a 52% reduction in MACCE incidence at 6 months with rosuvastatin reload therapy (p = 0.03).

Conclusions:

  • Preoperative rosuvastatin reload therapy is effective in reducing myocardial necrosis.
  • This strategy significantly decreases major adverse cardiovascular and cerebrovascular events (MACCE) following emergency noncardiac surgery in patients with stable CAD on long-term statin therapy.
Abstract

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