Statin therapy before cardiac surgery does not improve postoperative outcomes
In patients undergoing heart surgery, perioperative therapy with statins does not protect against postoperative cardiovascular and infectious outcomes, and may even be linked to increased risk of acute renal injury and poor hospital survival, according to a systematic review and meta-analysis.
The study included randomized controlled trials (RCTs), which compared preoperative statin therapy with placebo or no treatment in adult cardiac surgery. Postoperative outcomes were acute kidney injury, atrial fibrillation, myocardial infarction, stroke, infections and mortality.
A total of 23 RCTs involving 5,102 patients were identified. Both meta-analysis of trials with low risk of bias and trial sequential analysis showed that statin therapy was associated with increased acute kidney injury compared with placebo (23.82 vs 19.86 percent; odds ratio, 1.26; p=0.01), whereas no difference was observed in any of the other postoperative outcomes. Sensitivity analysis demonstrated an association between statin therapy and a slight increase in hospital mortality.According to researchers, the study was done in light of conflicting findings from available literature. While several studies suggest that perioperative therapy with statins has beneficial effects, more recent clinical trials showed that not only does it have any benefit on postoperative outcomes, it may even have detrimental effects on patients undergoing heart surgery. Thus, researchers recommend further evaluation of the efficacy and safety profile of statin therapy in this population.