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Published on: February 2, 2021
Long-Term Preoperative Atorvastatin or Rosuvastatin Use in Adult Patients before CABG Does Not Increase Incidence of
Vladimir Shvartz1, Eleonora Khugaeva1, Yuri Kryukov2
1Department of Surgical Treatment for Interactive Pathology, Bakulev Scientific Center for Cardiovascular Surgery, 121552 Moscow, Russia.
Insights
Long-term statin use before cardiac surgery did not increase acute kidney injury (AKI) risk. No significant difference in AKI incidence was found between atorvastatin and rosuvastatin groups post-cardiac bypass surgery.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Acute kidney injury (AKI) is a common complication following cardiac surgery.
- Statins possess anti-inflammatory and antioxidant properties that may prevent AKI.
- Previous studies on statin efficacy for AKI prevention show varied results.
Purpose of the Study:
- To evaluate the long-term effects of preoperative atorvastatin and rosuvastatin on AKI incidence after coronary artery bypass graft (CABG) surgery.
- To compare AKI rates between patients taking atorvastatin, rosuvastatin, and no statins.
- To assess the safety and efficacy of statin use in preventing AKI in cardiac surgery patients.
Main Methods:
- Retrospective cohort study of 958 patients undergoing CABG.
- Propensity score matching used to compare atorvastatin, rosuvastatin, and control groups.
- AKI incidence assessed using Kidney Disease: Improving Global Outcomes (KDIGO) criteria on postoperative days 2 and 4.
Main Results:
- No statistically significant difference in AKI incidence between atorvastatin and rosuvastatin groups on postoperative days 2 and 4.
- No significant difference in AKI incidence between rosuvastatin and control groups on postoperative days 2 and 4.
- No significant difference in AKI incidence between atorvastatin and control groups on postoperative days 2 and 4.
Conclusions:
- Long-term preoperative statin use (atorvastatin or rosuvastatin) does not increase the incidence of postoperative AKI after CABG.
- There is no significant difference in the incidence of post-CABG AKI between atorvastatin and rosuvastatin users.
- Statins appear safe for long-term use in patients undergoing CABG regarding AKI risk.
Background:
Acute kidney injury (AKI) is among the expected complications of cardiac surgery. Statins with pleiotropic anti-inflammatory and antioxidant effects may be effective in the prevention of AKI. However, the results of studies on the efficacy and safety of statins are varied and require further study.
Methods:
We conducted a retrospective cohort study to evaluate long-term preoperative intake of atorvastatin and rosuvastatin on the incidence of AKI, based on the "Kidney Disease: Improving Global Outcomes" (KDIGO) criteria in the early postoperative period after coronary artery bypass graft surgery (CABG). We performed propensity score matching to compare the findings in our study groups. The incidence of AKI was assessed on day 2 and day 4 after the surgery.
Results:
The analysis included 958 patients after CABG. After 1:1 individual matching, based on propensity score, the incidence of AKI was comparable both on day 2 after the surgery (7.4%) between the atorvastatin group and rosuvastatin group (6.5%) (OR: 1.182; 95%Cl 0.411-3.397; p = 0.794), and on postoperative day 4 between the atorvastatin group (3.7%) and the rosuvastatin group (4.6%) (OR: 0.723, 95%Cl 0.187-2.792; p = 0.739). Additionally, there were no statistically significant differences in terms of incidence of AKI after 1:1 individual matching, based on propensity score, between the rosuvastatin group and the control group both on postoperative day 2 (OR: 0.692; 95%Cl 0.252-1.899; p = 0.611) and day 4 (OR: 1.245; 95%Cl 0.525-2.953; p = 0.619); as well as between the atorvastatin group and the control group both on postoperative day 2 (OR: 0.549; 95%Cl 0.208-1.453; p = 0.240) and day 4 (OR: 0.580; 95%Cl 0.135-2.501; p = 0.497).
Conclusion:
Long-term statin use before CABG did not increase the incidence of postoperative AKI. Further, we revealed no difference in the incidence of post-CABG AKI between the atorvastatin and rosuvastatin groups.
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