Statins for surgical patients.

Abstract:

OBJECTIVE:To evaluate perioperative statin treatment, to explore the rapidly increasing body of literature on the pleiotropic effects of statins, and to suggest a rational strategy of perioperative risk reduction. SUMMARY OF BACKGROUND DATA:Vascular, cerebrovascular, and cardiovascular complications are all too common in surgery. Although treatment with beta-blockers is a well-established strategy for perioperative cardiac risk reduction, prophylaxis with statins enjoys a firm pathophysiologic basis. METHODS:A PubMed search for studies evaluating outcomes of statin treatment in surgical series was accomplished by evaluating all articles found with the keyword "surgery" and the MeSH term for statins "hydroxymethylglutaryl-CoA reductase inhibitors." Studies where no outcome was relatable to statin treatment were excluded as were studies dealing primarily with transplant surgery. An overview of the medical literature on statin use and cardiac outcome was also performed. Basic science investigations elucidating the mechanisms and effects of statins that may reduce perioperative risk were included. RESULTS:The pharmacology and pleiotropic effects of statins are delineated. Multiple beneficial outcomes are elucidated and explored. Statins prescribed in the perioperative period appear beneficial though only one clinical trial is available from which to make clinical recommendations. CONCLUSION:Evidence supports a rebound effect. Statin treatment should be instituted and must not be discontinued in surgical patients. Current literature suggests that statins are protective in the preoperative period.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Williams TM,Harken AH

doi

10.1097/SLA.0b013e3181492c0d

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

30-7

issue

1

eissn

0003-4932

issn

1528-1140

pii

00000658-200801000-00007

journal_volume

247

pub_type

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