Abstract
Background The purpose of this cohort study was to investigate the independent relationship between preoperative statin therapy (PST) and postoperative severe multiorgan failure, measured by the Sequential Organ Failure Assessment (SOFA) maximum greater than 11, in high-risk patients undergoing isolated coronary artery bypass grafting (CABG). Methods The present study is a perspective, single-center, cohort analysis enrolling high-risk patients undergoing CABG from Jan 1, 2018, to Dec 31, 2018, in Beijing Anzhen hospital. Results Among a total of 880 high-risk patients undergoing isolated CABG included in this study, 503 (57.2%) experienced statin therapy before CABG. The SOFA maximum was significantly lower in the PST group compared with the control group (7.8 ± 3.0 v 9.2 ± 3.4, P < 0.0001). Multivariate logistic regression analysis demonstrated the incidence of the severe multiorgan dysfunction, measured by SOFA maximum ≥11, was dramatically reduced in the PST group (OR, 0.68, 95% CI 0.50–0.92, P=0.013). Furthermore, preoperative statin therapy (PST) might be associated with a decreased risk of postoperative major adverse cardiovascular and cerebral events and acute kidney injury, but an increased risk of postoperative hepatic inadequacy. Conclusion SOFA maximum was significantly lower in the PST group compared with the control group and the incidence of the severe multiorgan dysfunction was dramatically reduced in the PST group. The findings of this study might shed new light on questions of positive or negative effects of PST on multiple organ function after high-risk CABG, so as to ultimately improve high-risk patient in-hospital outcomes from CABG.
Highlights
Previous studies demonstrated that the incidence of death in coronary artery bypass grafting (CABG) ranges from 2.94 to 32.5 according to different surgical severity and population [1, 2]. erefore, it is essential to develop prognostic models for accurately identify mortality and morbidity after isolated CABG, especially high-risk CABG
Previous studies only focused on one single organ, and no studies demonstrated the relationship between preoperative statin therapy (PST) and Cardiology Research and Practice severe multiple organ dysfunction after high-risk CABG. is may be ascribed to the lack of effective and comprehensive prediction models to evaluate postoperative multiple organ dysfunction. e appearance of Sequential Organ Failure Assessment (SOFA) maximum can solve this problem
Our key findings are: (1) the SOFA maximum was significantly lower in the PST group compared with the control group and multivariate logistic regression analysis on the total patients demonstrated the incidence of the severe multiorgan dysfunction, measured by SOFA maximum ≥11, was dramatically reduced in the PST group; (2) PST might be associated with a decreased risk of postoperative major adverse cardiovascular and cerebral events (MACCE) and acute kidney injury (AKI), but an increased risk of postoperative hepatic inadequacy
Summary
Previous studies demonstrated that the incidence of death in coronary artery bypass grafting (CABG) ranges from 2.94 to 32.5 according to different surgical severity and population [1, 2]. erefore, it is essential to develop prognostic models for accurately identify mortality and morbidity after isolated CABG, especially high-risk CABG. PST: preoperative statin therapy; CABG: coronary artery bypass grafting; MACCE: major adverse cardiovascular and cerebral events; LVEF: left ventricular ejection fraction; BMI: body mass index; MI: myocardial infarction; TIA: prior transient ischemic attacks; CVA: cerebral vascular accident; PVD: previous peripheral vascular diseases; DM: diabetes mellitus; NYHA : New York Heart Association, ACEI: angiotensin-converting enzyme inhibitors; ARB: angiotensin receptor blockers.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
