Effects of perioperative statins on patient outcomes after noncardiac surgery: a meta-analysis

Ma, Ben; Sun, Jin; Diao, Shanshan; Zheng, Bo; Li, Hua

doi:10.1080/07853890.2018.1471217

Cited by 25 publications

(23 citation statements)

References 31 publications

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“…In 2018, a meta-analysis of 12 randomized controlled trials (2004 to 2017) involving more than 4,700 noncardiac surgery patients was conducted to investigate whether statins improve such perioperative outcomes. 57 Compared to the control arms, the statin groups demonstrated a reduced incidence of myocardial infarction, atrial fibrillation, and a composite outcome including mortality. However, groups randomized to statin therapy did not demonstrate a significant reduction in perioperative stroke or transient ischemic attack risk.…”

Section: Perioperative Strokementioning

confidence: 96%

Stroke in Surgical Patients

Vlisides

Moore

2021

Anesthesiology

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Stroke is associated with substantial morbidity and mortality. The aim of this review is to provide an evidence-based synthesis of the literature related to perioperative stroke, including its etiology, common risk factors, and potential risk reduction strategies. In addition, the authors will discuss screening methods for the detection of postoperative cerebral ischemia and how multidisciplinary collaborations, including endovascular interventions, should be considered to improve patient outcomes. Lastly, the authors will discuss the clinical and scientific knowledge gaps that need to be addressed to reduce the incidence and improve outcomes after perioperative stroke.

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Section: Perioperative Strokementioning

confidence: 96%

Stroke in Surgical Patients

Vlisides

Moore

2021

Anesthesiology

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“…Hung et al 26 observed that the statins can significantly reduce the risk of new‐onset AF in elderly HTN patients those aged ≥64 years, and the patients with CHADS2 score ≥ 2 benefited more than those with a score of 1. In addition, Ma et al 27 confirmed that statins can reduce the risk of AF in the elderly aged ≥65 years by about 19%. Furthermore, Kunt et al 28 showed that atorvastatin can significantly reduce the incidence of AF and the mortality of cardiovascular events in those elderly patients who had underwent coronary artery bypass grafting (CABG) before.…”

Section: Discussionmentioning

confidence: 99%

Combined treatment with valsartan and fluvastatin to delay disease progression in nonpermanent atrial fibrillation with hypertension: A clinical trial

Zhao

Wang

et al. 2020

Clinical Cardiology

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Background: Atrial fibrillation (AF) is a complex cardiac arrhythmia in clinical practice with increasing incidence. However, the effects of statins on patients with AF are not quite clear. Hypothesis: To investigate the protective effect of calcium channel blocker (CCB) and valsartan combined fluvastatin on hypertension (HTN) patients with nonpermanent AF. Methods: In three and a half years, 189 cases of patients diagnosed as HTN combining nonpermanent AF by eight medical centers, were recruited and randomly assigned to four groups with varied treatments: CCB group; CCB + statin group; valsartan group; and valsartan + statin group. The four groups were followed up for 24 months. The 7-day Holter ultrasound echocardiography (UCG) and biochemical indexes were completed at preset time nodes respectively. Results: After 24 months of follow-up, 178 patients completed the study. Compared with CCB group, the blood lipid level, inflammatory index, ultrasonic index and electrocardiographic measurement results of CCB + statin group, valsartan group and valsartan + statin group were improved in different degrees and had statistical significance (P < .05 or P < .01). Furthermore, the improvement trend of CCB + statin group and valsartan + statin group was more obvious. Conclusions: The results indicated that valsartan can reduce AF load and recurrence rate, and delay the progression of nonpermanent AF to permanent AF in multiple ways, and the effect of combination of valsartan and fluvastatin is more significant. These results provide a new direction for the integrated upstream control strategy of AF.

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“…The association of the discontinuation of statins with the risk of worse outcomes is not unprecedented. Perioperative exposure to atorvastatin has been associated with a reduction in the risk of mortality and certain complications 19–21 . Furthermore, patients who stopped statin therapy after a myocardial infarction had a higher risk of mortality than patients who never used statins 22 .…”

Section: Discussionmentioning

confidence: 99%

Discontinuation of atorvastatin use in hospital is associated with increased risk of mortality in COVID‐19 patients

Andrews

Goldin

Shen

et al. 2022

Journal of Hospital Medicine

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Background: Statins are a commonly used class of drugs, and reports have suggested that their use may affect COVID-19 disease severity and mortality risk.Objective: The purpose of this analysis was to determine the effect of discontinuation of previous atorvastatin therapy in patients hospitalized for COVID-19 on the risk of mortality and ventilation.Methods: Data from 146,413 hospitalized COVID-19 patients were classified according to statin therapy. Home + in hospital atorvastatin use (continuation of therapy); home + no in hospital atorvastatin use (discontinuation of therapy); no home + no in hospital atorvastatin use (no statins). Logistic regression was performed to assess the association between atorvastatin administration and either mortality or use of mechanical ventilation during the encounter.Results: Continuous use of atorvastatin (home and in hospital) was associated with a 35% reduction in the odds of mortality compared to patients who received atorvastatin at home but not in hospital (odds ratio [OR]: 0.65, 95% confidence interval [CI]: 0.59-0.72, p < .001). Similarly, the odds of ventilation were lower with continuous atorvastatin therapy (OR: 0.70, 95% CI: 0.64-0.77, p < .001).Conclusions: Discontinuation of previous atorvastatin therapy is associated with worse outcomes for COVID-19 patients. Providers should consider maintaining existing statin therapy for patients with known or suspected previous use.

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Effects of perioperative statins on patient outcomes after noncardiac surgery: a meta-analysis

Cited by 25 publications

References 31 publications

Stroke in Surgical Patients

Stroke in Surgical Patients

Combined treatment with valsartan and fluvastatin to delay disease progression in nonpermanent atrial fibrillation with hypertension: A clinical trial

Discontinuation of atorvastatin use in hospital is associated with increased risk of mortality in COVID‐19 patients

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