Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Abstract

OBJECTIVE:

The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory response.

DESIGN:

Retrospective observational study of patients undergoing coronary artery bypass grafting surgery.

SETTING:

Referral center for cardiothoracic surgery at a university hospital.

PARTICIPANTS:

Four hundred forty patients undergoing coronary artery bypass grafting surgery with cardiopulmonary bypass.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Thirty-five percent of patients received statins in the preoperative period. Multivariable analysis revealed no effect of preoperative statin therapy on cognitive function (p = 0.67). Post hoc analysis revealed that statin therapy at hospital discharge was associated with less improvement in cognitive performance at 6 weeks after surgery (p = 0.011). No significant differences were found between statin therapy groups in either range or maximum value of any of the cytokines (p > 0.05).

CONCLUSIONS:

Preoperative statin therapy did not decrease the inflammatory response to cardiopulmonary bypass or the cognitive dysfunction commonly seen after cardiac surgery.

• Authors: Joseph P Mathew, Hilary P Grocott, James R McCurdy, Lian K Ti, R Duane Davis, Daniel T Laskowitz, Mihai V Podgoreanu, Madhav Swaminathan, John Lynch, Mark Stafford-Smith, William D White, Mark F Newman
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 19 Issue 3 Pg. 294-9 (Jun 2005) ISSN: 1053-0770 [Print] United States
• PMID: 16130053 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• IL2RA protein, human
• Interleukin-2 Receptor alpha Subunit
• Interleukin-6
• Receptors, Interleukin
• Tumor Necrosis Factor-alpha
• C-Reactive Protein

Topics

• C-Reactive Protein (drug effects)
• Cardiopulmonary Bypass (adverse effects)
• Cognition Disorders (drug therapy, etiology, prevention & control)
• Coronary Artery Bypass (adverse effects, methods)
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, therapeutic use)
• Inflammation (drug therapy)
• Interleukin-2 Receptor alpha Subunit
• Interleukin-6 (blood)
• Male
• Middle Aged
• Postoperative Complications (drug therapy, etiology, prevention & control)
• Preoperative Care (methods)
• Receptors, Interleukin (blood, drug effects)
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Failure
• Tumor Necrosis Factor-alpha (drug effects)