A review of perioperative statin therapy for noncardiac surgery.

Abstract

The leading cause of perioperative morbidity and mortality after major noncardiac surgery is cardiovascular complications. Clinical trials of lipid-lowering 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) have shown improved cardiovascular outcomes; therefore, statins have become a mainstay in the prevention of cardiovascular disease. Retrospective trials and a small number of prospective randomized trials indicate that statin use may be beneficial during the perioperative period. In addition to the effects on serum lipid levels, statins influence inflammatory, thrombotic, and vasodilatory cellular pathways; and thus, their beneficial effects are not limited to patients with hypercholesterolemia. This review will (1) examine the evidence for using perioperative statin therapy in the noncardiac surgical patient (2) explore the possible consequences of statin withdrawal, and (3) revisit the evidence for the safety of statin use. Further studies are still needed to establish the optimal dosage as well as timing and length of statin therapy perioperatively.

• Authors: Sara Skrlin, Vivian Hou
• Journal: Seminars in cardiothoracic and vascular anesthesia (Semin Cardiothorac Vasc Anesth) Vol. 14 Issue 4 Pg. 283-90 (Dec 2010) ISSN: 1940-5596 [Electronic] United States
• PMID: 21041202 (Publication Type: Journal Article, Review)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipids

Topics

• Cardiovascular Diseases (etiology, prevention & control)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Lipids (blood)
• Perioperative Care (methods)
• Postoperative Complications (prevention & control)
• Substance Withdrawal Syndrome (physiopathology)
• Surgical Procedures, Operative (methods)