Statin therapy benefits heart surgery patients

Giving statins in advance to heart surgery patients improves outcomes, says a new review of the evidence.

Statins reduce blood cholesterol levels, which helps prevent the risk of death among people with coronary heart disease. The research to date has been unclear on the benefit of statins for patients about to undergo heart surgery.

Lead author of the Cochrane systematic review, Dr Oliver Liakopoulos of the University of Cologne, Germany, and his team analysed figures from 11 randomised controlled studies including a total of 984 heart surgery patients.

Compared with no statins, taking statins before the surgery reduced the rate of post-operative atrial fibrillation, that is, irregular heartbeat linked with palpitations, fainting, chest pain, congestive heart failure and stroke.

These patients also left the intensive care unit an average of three-and-a half hours earlier than patients not given statins in advance of their operation, and were discharged from hospital an average of half a day earlier.

But no significant reduction was seen in the proportion of patients who went on to have a heart attack or kidney failure, and statin use did not reduce the rate of death or stroke following the operation.

Dr Liakopoulos points out: "Since the data we analysed had come mainly from patients having coronary artery bypass operations, the results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery."

He adds: "To get a clearer picture of the potential benefits of taking statins before a heart operation, we need to have more clinical trials and find out whether clinical outcomes can be further improved if patients use special statin dosing regimens shortly before a heart procedure."

Preoperative statin therapy for patients undergoing cardiac surgery. Liakopoulos, O. J. et al. Cochrane Database of Systematic Reviews 2012, Issue 4. Art. No.: CD008493. doi: 10.1002/14651858.CD008493.pub2.