Preoperative statins have been associated with decreased mortality after coronary
artery bypass grafting. Data are limited on whether these benefits extend to patients
undergoing cardiac valve surgery. We examined whether preoperative statins decrease
morbidity and mortality in patients undergoing isolated cardiac valve surgery. In
a retrospective cohort analysis of consecutive patients who underwent surgical valve
repair or replacement (excluding concomitant coronary artery bypass grafting, aortic
root replacement, or ventricular assist device placement) at St. Luke's Episcopal
Hospital, the primary outcome was 30-day mortality. Secondary outcomes included 30-day
major adverse events (composite of early mortality, postoperative myocardial infarction,
or stroke). Of 825 patients, 31% received preoperative statins (n = 255). Logistic
regression analysis revealed that age >65 years (p = 0.02), history of congestive
heart failure (p = 0.001), and total bypass time >80 minutes (p = 0.01) were independent
predictors of increased 30-day mortality. Preoperative statin therapy was not associated
with decreased 30-day mortality (odds ratio 0.89, 95% confidence interval 0.38 to
2.03), major adverse events (odds ratio 1.09, 95% confidence interval 0.61 to 1.96),
postoperative myocardial infarction (p = 0.70), or stroke (p = 0.57). At a mean follow-up
of 1.57 years, preoperative statin therapy was not associated with decreased mortality
(p = 0.81). In the analysis using propensity score matching (354 propensity-matched
patients, 177 in each group), preoperative statin was not associated with improved
primary or secondary outcomes. In conclusion, preoperative statin therapy was not
associated with a decrease in morbidity or mortality in patients undergoing isolated
cardiac valve surgery.
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Article info
Publication history
Published online: August 29, 2008
Accepted:
June 20,
2008
Received in revised form:
June 20,
2008
Received:
April 17,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
