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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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Statin Therapy in Patients Undergoing Thoracic Aorta Replacement for Aortic Aneurysms
Bogdan A Kindzelski1, Andrea L Hanick1, Kyle G Miletic1
1Aorta Center, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Aorta (Stamford, Conn.)
|November 8, 2021
Summary
Statin therapy is often given to patients undergoing thoracic aortic aneurysm surgery without clear benefit. While not increasing mortality or reoperation risk, statins were linked to higher rates of postoperative kidney failure.
Area of Science:
- Cardiovascular Surgery
- Pharmacology
- Nephrology
Background:
- Thoracic aortic aneurysm (TAA) surgery patients often receive statin therapy, sometimes without clear indications.
- The study aimed to assess the prevalence and impact of preoperative statin use in TAA repair.
Purpose of the Study:
- To determine the frequency of statin use in patients undergoing TAA surgery.
- To investigate the association between preoperative statin use and perioperative and long-term outcomes after TAA repair.
Main Methods:
- A cohort of 1,839 patients undergoing aortic replacement for degenerative TAA between 2005 and 2011 was analyzed.
- Propensity score matching was employed to compare outcomes between 570 statin users and non-statin users, adjusting for 56 preoperative variables.
Main Results:
- Perioperative outcomes like mortality and stroke were similar between matched statin and non-statin groups.
- Statin users showed a significantly higher incidence of temporary postoperative dialysis (2.8% vs. 0.88%, p=0.02).
- Intermediate-term follow-up revealed no significant differences in aortic reintervention or all-cause mortality between groups.
Conclusions:
- Preoperative statin use in TAA surgery patients is common and may not be indicated in the absence of other cardiovascular comorbidities.
- Statin therapy in this context was associated with an increased risk of postoperative renal failure.
- TAA itself should not be an indication for statin initiation without established evidence-based reasons.
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