Background. Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed.Methods. Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias.Results. The overall 30-day mortality rate was 2.7%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32 to 0.89; p = 0.001), postoperative cardiac arrhythmias (OR, 0.76; 95% CI, 0.62 to 0.93; p < 0.006), and stroke (OR, 0.54; 95% CI, 0.32 to 0.92; p = 0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (chi(2), 4.41; hazard ratio [HR], 1.59; 95% CI, 1.13 to 2.27; p = 0.03), stroke (chi(2), 11.42; HR, 2.15; 95% CI, 1.37 to 3.27; p = 0.0007), cardiac arrhythmias (chi(2), 19.9; HR, 2.13; 95% CI, 1.81 to 2.72; p < 0.0001), and major adverse cardiac and cerebrovascular events (chi(2), 3.74; HR, 1.37; 95% CI, 0.99 to 1.74; p = 0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up.Conclusions. Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations. (Ann Thorac Surg 2011;92:68-73) (C) 2011 by The Society of Thoracic Surgeons
Statins improve outcome in isolated heart valve operations: A propensity score analysis of 3,217 patients
Benedetto U.;
2011-01-01
Abstract
Background. Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed.Methods. Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias.Results. The overall 30-day mortality rate was 2.7%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32 to 0.89; p = 0.001), postoperative cardiac arrhythmias (OR, 0.76; 95% CI, 0.62 to 0.93; p < 0.006), and stroke (OR, 0.54; 95% CI, 0.32 to 0.92; p = 0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (chi(2), 4.41; hazard ratio [HR], 1.59; 95% CI, 1.13 to 2.27; p = 0.03), stroke (chi(2), 11.42; HR, 2.15; 95% CI, 1.37 to 3.27; p = 0.0007), cardiac arrhythmias (chi(2), 19.9; HR, 2.13; 95% CI, 1.81 to 2.72; p < 0.0001), and major adverse cardiac and cerebrovascular events (chi(2), 3.74; HR, 1.37; 95% CI, 0.99 to 1.74; p = 0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up.Conclusions. Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations. (Ann Thorac Surg 2011;92:68-73) (C) 2011 by The Society of Thoracic SurgeonsFile | Dimensione | Formato | |
---|---|---|---|
PIIS0003497511005443.pdf
Solo gestori archivio
Tipologia:
PDF editoriale
Dimensione
514.03 kB
Formato
Adobe PDF
|
514.03 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.