Safety of perioperative statin use in high-risk patients undergoing major vascular surgery

Schouten, Olaf; Kertai, Miklós D.; Bax, Jeroen J.; Durazzo, A; Biagini, Elena; Boersma, Eric; Waning, Virginie H. van; Lameris, Thomas W.; Sambeek, Marc R.H.M. van; Poldermans, Don

doi:10.1016/j.amjcard.2004.10.046

Cited by 113 publications

(92 citation statements)

References 3 publications

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“…However, although the occurrence of elevated liver function tests and myopathy are theoretically important, the overwhelming majority of perioperative statin studies in noncardiac surgery have not found this to be a major occurrence. 39 Nonetheless, a lack of uniform definitions and appropriate surveillance for adverse events are important limitations to this finding. In our recent systematic review, we were unable to provide refined estimates of these important side effects owing to differences in definition, variations in screening, and absence of standardized cutoffs used in studies.…”

Section: Clinical Insights Into Failure Of Postoperative Statin Resummentioning

confidence: 99%

Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies

Fallouh

Chopra

2012

Journal of Hospital Medicine

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BACKGROUND: A growing body of research suggests that statins improve perioperative cardiac outcomes by attenuating inflammation. Conversely, some studies suggest that withdrawal of statins after surgery results in an upsurge of inflammation and adverse cardiac outcomes. METHODS: We performed a literature search using multiple medical databases to examine the basic, clinical, and experimental evidence supporting the existence of a statin withdrawal state. Studies examining outcomes associated with statin withdrawal were narratively synthesized. RESULTS: Published evidence suggests that statin withdrawal is associated with worse cardiac outcomes in a variety of scenarios, including acute coronary syndrome, ischemic stroke, and surgery. Although certain reasons for postoperative statin cessation are difficult to avoid (eg, ileus after surgery), we posit that many perioperative clinicians may be unaware of the importance of statin resumption in a timely fashion. This lack of awareness translates into preventable harm and an opportunity for outcome improvement. We introduce innovative practices through which perioperative practitioners may prevent statin discontinuation. CONCLUSIONS: Ensuring the resumption of statins after surgery should become routine practice for perioperative providers. We highlight knowledge gaps and identify a research agenda aimed at better understanding this practice. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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Section: Clinical Insights Into Failure Of Postoperative Statin Resummentioning

confidence: 99%

Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies

Fallouh

Chopra

2012

Journal of Hospital Medicine

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“…The use of statins in the perioperative period is safe. Although patients using statins have a higher baseline CPK level, the occurrence of elevation greater than five times its reference value or rhabdomyolysis is rare 185 .…”

Section: Statinsmentioning

confidence: 99%

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

Feitosa¹,

Marques²,

Caramelli³

et al. 2011

Arq. Bras. Cardiol.

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“…The findings of numerous clinical studies suggest that perioperative statin therapy is associated with improved cardiac outcome during noncardiac surgery, 22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] endovascular interventions, 39,42 as well as during cardiac surgery, 22,36,37,43,44 including protection against arrhythmias. 45,46 Much, if not all, of the beneficial effects of statins on cardiovascular outcome are likely due to their pleiotropic actions, rather than their lipid-lowering actions.…”

Section: Perioperative Use Of Statinsmentioning

confidence: 99%

Statins and other drugs that make a difference

Priebe

2008

Southern African Journal of Anaesthesia and Analgesia

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): 92-95 ABSTRACTThe aetiology of perioperative cardiac morbidity and mortality is multifactorial. With the many and diverse aetiological factors involved, it is highly unlikely that one single intervention will successfully improve cardiac outcome following noncardiac surgery. Based on increasing knowledge of the nature of atherosclerotic coronary artery disease, and in view of the poor positive predictive value of the non-invasive cardiac stress tests and the considerable risk of coronary angiography and coronary revascularisation in high-risk patients, the paradigm is shifting from an emphasis on extensive non-invasive preoperative risk stratification to an emphasis on a combination of selective non-invasive testing and aggressive pharmacological perioperative therapy. Perioperative plaque stabilisation by pharmacological means may well be one of the most important cardioprotective interventions.

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Safety of perioperative statin use in high-risk patients undergoing major vascular surgery

Cited by 113 publications

References 3 publications

Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies

Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

Statins and other drugs that make a difference

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