Abstract
Statin therapy may prevent an excessive inflammatory response after cardiopulmonary bypass for cardiac surgery. In a recent issue of Critical Care, Morgan and colleagues present data from a well-conducted systematic review and meta-analysis of randomised controlled trials using inflammatory markers as primary outcome measure. They find that pre-operative statin therapy, compared with placebo, may reduce various post-operative markers of systemic inflammation (IL-6, IL-8, C-reactive protein, tumour necrosis factor-alpha). Their ability to make definitive conclusions is limited, however, by the suboptimal methodological quality of the primary studies. Their review suggests that ICU researchers should focus on developing valid surrogate markers and use these to accurately describe the mechanisms and effectiveness of novel therapies before proceeding to large pragmatic trials using mortality as primary outcome.
Highlights
The randomised controlled trials included by Morgan and colleagues measured post-operative inflammatory markers in adults receiving a statin or placebo prior to cardiopulmonary bypass (CPB)
In a recent issue of Critical Care, Morgan and colleagues present the results of a well-conducted systematic review and meta-analysis of the effect of statin therapy on inflammatory markers after cardiac surgery [1]
The randomised controlled trials included by Morgan and colleagues measured post-operative inflammatory markers in adults receiving a statin or placebo prior to CPB
Summary
In a recent issue of Critical Care, Morgan and colleagues present the results of a well-conducted systematic review and meta-analysis of the effect of statin therapy on inflammatory markers after cardiac surgery [1]. In this context cardiopulmonary bypass (CPB) is appealing methodologically because it allows the study of preventive interventions [4,5,6]. The randomised controlled trials included by Morgan and colleagues measured post-operative inflammatory markers in adults receiving a statin or placebo prior to CPB.
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