To investigate the incidence of perioperative myocardial infarction (MI) and of 2-year mortality in patients undergoing noncardiac vascular surgery treated with and without statins.
Of 577 patients, mean age 73 years, undergoing noncardiac vascular surgery (300 with carotid endarterectomy, 179 with lower extremity revascularization, and 98 with abdominal aortic aneursysm repair), 302 (52%) were treated with statins and 275 (48%) with no lipid-lowering drug therapy. We investigated the perioperative MI incidence and 2-year mortality in patients treated with and without statins.
The mean age, gender, body mass index, prevalence of smoking, hypertension, diabetes, prior stroke or transient ischemic attack, and prior coronary artery disease, and use of antiplatelet drugs, beta blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were not significantly different between patients treated with and without statins. Dyslipidemia was present in 302 of 302 patients (100%) treated with statins and in 192 of 275 patients (70%) not treated with statins (p<0.0001). Perioperative MI occurred in 20 of 302 patients (7%) treated with statins and in 38 of 275 patients (14%) not treated with statins (p = 0.005). At 2-year follow-up, 18 of 302 patients (6%) treated with statins and 43 of 275 patients (16%) not treated with statins died (p = 0.0002).
Use of statins significantly reduced perioperative MI and 2-year mortality in patients undergoing carotid endarterectomy or lower extremity revascularization or abdominal aortic aneurysm repair.
Statins should be used perioperatively and during long-term follow-up in patients undergoing noncardiac vascular surgery to reduce perioperative MI and long-term mortality.
Harit Desai, No Financial Disclosure Information; No Product/Research Disclosure Information