Preoperative statin administration is associated with lower mortality and decreased need for postoperative hemodialysis in patients undergoing coronary artery bypass graft surgery

Abstract

Objective: The purpose of this study was to examine the effect of perioperative statin administration on renal outcomes after cardiac surgery.

Design: A retrospective chart review.

Setting: A university hospital.

Participants: Patients presenting for cardiac surgery.

Interventions: The records of 2,760 patients admitted for coronary artery bypass graft (CABG) surgery from 1997 to 2006 were reviewed. In-hospital mortality, the need for renal replacement therapy (RRT), and acute renal failure (ARF) were considered the primary outcomes. Univariate and multiple logistic regression analyses were performed to assess the relationship between each outcome and statin therapy while adjusting for other patient characteristics.

Main results: Of the 2,760 patients, 1,557 were taking preoperative statins. On univariate analysis, the mortality rate for patients receiving statins was 2.4% versus 4.2% for those not receiving statins (p = 0.008). The requirement for RRT was 1.9% for patients receiving statins versus 3.6% for those not receiving statins (p = 0.011). The incidence of ARF was not statistically significant between groups (28% v 27.5%). On multivariate analysis, statin therapy was associated with a 43% decrease in the risk of death and a 46% decrease in the risk of RRT, but statins were not associated with a decreased risk of ARF. Also, the beneficial effects of statins were age-dependent, with younger patients experiencing a greater advantage.

Conclusions: The preoperative use of statins is associated with decreased in-hospital mortality and a reduction in the need for RRT.