Statins Are Associated With a Reduced Incidence of Perioperative Mortality in Patients Undergoing Major Noncardiac Vascular Surgery

Abstract

Underlying coronary heart disease may put patients undergoing major vascular surgery at increased risk of perioperative mortality. Perioperative mortality may be reduced by statins (inhibitors of 3-hydroxy-3-methalglutaryl coenzyme A) because they improve lipid profiles and also stabilize coronary plaques on the vascular wall. The authors evaluated the association between perioperative morality and statin use by conducting a case-control study among 2816 patients at Erasmus Medical Center who had major vascular surgery between 1991 and 2000. The case subjects were the 5.8% (160 patients) who died during the hospital stay after surgery. Two controls were selected from the remaining patients for each case and were sorted according to calendar year and type of procedure. Information on statin use before surgery, use of other cardiovascular medication, and the presence of cardiac risk factors was obtained for cases and controls. The primary cause of death in 65% (104) of the case subjects was a vascular complication. The controls had significantly more statin use than the case subjects (25% versus 8%). Similar results were obtained in subgroups of patients according to the use of cardiovascular therapy and the presence of cardiac risk factors. The authors concluded that statin reduces perioperative mortality in patients who undergo major vascular surgery.