Statins and Perioperative Mortality


Clinical summary

Indications

Cautions

Side effects

Dose

Notes

Hypercholesterolemia

Primary and secondary prevention of cardiovascular disease
 
Muscle-related (myalgia, myopathy, myonecrosis, rhabdomyolysis) in 1.5–5 % of the patients

Isolated increase in liver enzymes (usually benign)

Depending on particular statin: 10–80 mg once daily

Statin therapy should be continued in perioperative period

Reducing perioperative risk in cardiac, vascular, and major noncardiac surgery

Possible increased occurrence of postoperative AKI and ambiguous effect on mortality
  
Existing statin therapy should be continued; commencement of new statin therapy treatment before the surgery (1–3 weeks) could be considered with appropriate caution






References



1.

Zhou Q, Liao JK (2010) Pleiotropic effects of statins. Basic research and clinical perspectives. Circ J 74:818–826CrossRefPubMedPubMedCentral


2.

Landoni G, Rodseth RN, Santini F et al (2012) Randomized evidence for reduction of perioperative mortality. J Cardiothorac Vasc Anesth 26:764–772CrossRefPubMed


3.

Landoni G, Pisano A, Lomivorotov V et al (2016) Randomized evidence for reduction of perioperative mortality: an updated consensus process. J Cardiothorac Vasc Anesth. 2016 Aug 2. pii: S1053-0770(16)30281-6. doi:10.​1053/​j.​jvca.​2016.​07.​017. [Epub ahead of print]


4.

Christenson JT (1999) Preoperative lipid-control with simvastatin reduces the risk of postoperative thrombocytosis and thrombotic complications following CABG. Eur J Cardiothorac Surg 15:394–399CrossRefPubMed


5.

Schouten O, Boersma E, Hoeks SE et al (2009) Fluvastatin and perioperative events in patients undergoing vascular surgery. N Engl J Med 361:980–989CrossRefPubMed


6.

Venkatesan S, Okoli GN, Mozid AM et al (2016) Effects of five preoperative cardiovascular drugs on mortality after coronary artery bypass surgery: a retrospective analysis of an observational study of 16 192 patients. Eur J Anaesthesiol 33:49–57CrossRefPubMed


7.

de Waal BA, Buise MP, van Zundert AA (2015) Perioperative statin therapy in patients at high risk for cardiovascular morbidity undergoing surgery: a review. Br J Anaesth 114:44–52CrossRefPubMed


8.

Edwards JE, Moore RA (2003) Statins in hypercholesterolaemia: a dose-specific meta-analysis of lipid changes in randomised, double blind trials. BMC Fam Pract 4:18CrossRefPubMedPubMedCentral


9.

Gazzerro P, Proto MC, Gangemi G et al (2012) Pharmacological actions of statins: a critical appraisal in the management of cancer. Pharmacol Rev 64:102–146CrossRefPubMed

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Oct 9, 2017 | Posted by in Uncategorized | Comments Off on Statins and Perioperative Mortality

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