Preoperative statin therapy decreases risk of postoperative renal insufficiency

Salim S. Virani, Vijay Nambi, Venkateshwar R. Polsani, Vei Vei Lee, MacArthur Elayda, Shun Kosaka, Wei Pan, Ross M. Reul, James M. Wilson, Laura A. Petersen, James T. Willerson, Christie M. Ballantyne

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Introduction: Although current guidelines recommend withholding statins in perioperative patients, little information is available on whether perioperative statin use increases risk for postoperative renal failure. Aims: We examined the relation between preoperative statin therapy and postoperative risk for renal insufficiency in patients undergoing cardiac surgery. Methods: Retrospective cohort review from the Texas Heart Institute research database was performed. Patients were divided into two groups: those who received preoperative statins and those who did not. Primary outcome was the development of postoperative renal insufficiency (requiring dialysis or not). Outcomes were assessed in the entire cohort and in subgroups undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, or combined CABG and valve surgery. Results: Of 3001 patients, 56% received preoperative statins. In multivariate logistic regression analysis, preoperative statins were associated with significant reductions in risk for postoperative renal insufficiency in the entire cohort (odds ratio [OR] = 0.60, 95% confidence interval [CI] 0.38-0.95) and in patients undergoing isolated CABG (OR = 0.34, 95% CI 0.17-0.68). In patients undergoing isolated valve surgery (OR = 1.35, 95% CI 0.61-2.96) or combined CABG and valve surgery (OR = 1.39, 95% CI 0.48-3.99), preoperative statins were not associated with decreased incidence of postoperative renal insufficiency. Age >65 years, preoperative renal insufficiency, history of congestive heart failure, preoperative intra-aortic balloon pump insertion, and total cardiopulmonary bypass time >80 min were also independent predictors associated with increased risk for postoperative renal insufficiency. Conclusions: Preoperative statin therapy was associated with decreased incidence of postoperative renal insufficiency in patients undergoing cardiac surgeries, particularly in patients undergoing isolated CABG.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalCardiovascular Therapeutics
Volume28
Issue number2
DOIs
Publication statusPublished - 2010 Apr

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Renal Insufficiency
Coronary Artery Bypass
Odds Ratio
Confidence Intervals
Therapeutics
Thoracic Surgery
Incidence
Risk Reduction Behavior
Cardiopulmonary Bypass
Dialysis
Heart Failure
Logistic Models
Regression Analysis
Databases
Guidelines

Keywords

  • Renal insufficiency
  • Statins
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)
  • Pharmacology

Cite this

Virani, S. S., Nambi, V., Polsani, V. R., Lee, V. V., Elayda, M., Kosaka, S., ... Ballantyne, C. M. (2010). Preoperative statin therapy decreases risk of postoperative renal insufficiency. Cardiovascular Therapeutics, 28(2), 80-86. https://doi.org/10.1111/j.1755-5922.2009.00124.x

Preoperative statin therapy decreases risk of postoperative renal insufficiency. / Virani, Salim S.; Nambi, Vijay; Polsani, Venkateshwar R.; Lee, Vei Vei; Elayda, MacArthur; Kosaka, Shun; Pan, Wei; Reul, Ross M.; Wilson, James M.; Petersen, Laura A.; Willerson, James T.; Ballantyne, Christie M.

In: Cardiovascular Therapeutics, Vol. 28, No. 2, 04.2010, p. 80-86.

Research output: Contribution to journalArticle

Virani, SS, Nambi, V, Polsani, VR, Lee, VV, Elayda, M, Kosaka, S, Pan, W, Reul, RM, Wilson, JM, Petersen, LA, Willerson, JT & Ballantyne, CM 2010, 'Preoperative statin therapy decreases risk of postoperative renal insufficiency', Cardiovascular Therapeutics, vol. 28, no. 2, pp. 80-86. https://doi.org/10.1111/j.1755-5922.2009.00124.x
Virani, Salim S. ; Nambi, Vijay ; Polsani, Venkateshwar R. ; Lee, Vei Vei ; Elayda, MacArthur ; Kosaka, Shun ; Pan, Wei ; Reul, Ross M. ; Wilson, James M. ; Petersen, Laura A. ; Willerson, James T. ; Ballantyne, Christie M. / Preoperative statin therapy decreases risk of postoperative renal insufficiency. In: Cardiovascular Therapeutics. 2010 ; Vol. 28, No. 2. pp. 80-86.
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AU - Virani, Salim S.

AU - Nambi, Vijay

AU - Polsani, Venkateshwar R.

AU - Lee, Vei Vei

AU - Elayda, MacArthur

AU - Kosaka, Shun

AU - Pan, Wei

AU - Reul, Ross M.

AU - Wilson, James M.

AU - Petersen, Laura A.

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N2 - Introduction: Although current guidelines recommend withholding statins in perioperative patients, little information is available on whether perioperative statin use increases risk for postoperative renal failure. Aims: We examined the relation between preoperative statin therapy and postoperative risk for renal insufficiency in patients undergoing cardiac surgery. Methods: Retrospective cohort review from the Texas Heart Institute research database was performed. Patients were divided into two groups: those who received preoperative statins and those who did not. Primary outcome was the development of postoperative renal insufficiency (requiring dialysis or not). Outcomes were assessed in the entire cohort and in subgroups undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, or combined CABG and valve surgery. Results: Of 3001 patients, 56% received preoperative statins. In multivariate logistic regression analysis, preoperative statins were associated with significant reductions in risk for postoperative renal insufficiency in the entire cohort (odds ratio [OR] = 0.60, 95% confidence interval [CI] 0.38-0.95) and in patients undergoing isolated CABG (OR = 0.34, 95% CI 0.17-0.68). In patients undergoing isolated valve surgery (OR = 1.35, 95% CI 0.61-2.96) or combined CABG and valve surgery (OR = 1.39, 95% CI 0.48-3.99), preoperative statins were not associated with decreased incidence of postoperative renal insufficiency. Age >65 years, preoperative renal insufficiency, history of congestive heart failure, preoperative intra-aortic balloon pump insertion, and total cardiopulmonary bypass time >80 min were also independent predictors associated with increased risk for postoperative renal insufficiency. Conclusions: Preoperative statin therapy was associated with decreased incidence of postoperative renal insufficiency in patients undergoing cardiac surgeries, particularly in patients undergoing isolated CABG.

AB - Introduction: Although current guidelines recommend withholding statins in perioperative patients, little information is available on whether perioperative statin use increases risk for postoperative renal failure. Aims: We examined the relation between preoperative statin therapy and postoperative risk for renal insufficiency in patients undergoing cardiac surgery. Methods: Retrospective cohort review from the Texas Heart Institute research database was performed. Patients were divided into two groups: those who received preoperative statins and those who did not. Primary outcome was the development of postoperative renal insufficiency (requiring dialysis or not). Outcomes were assessed in the entire cohort and in subgroups undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, or combined CABG and valve surgery. Results: Of 3001 patients, 56% received preoperative statins. In multivariate logistic regression analysis, preoperative statins were associated with significant reductions in risk for postoperative renal insufficiency in the entire cohort (odds ratio [OR] = 0.60, 95% confidence interval [CI] 0.38-0.95) and in patients undergoing isolated CABG (OR = 0.34, 95% CI 0.17-0.68). In patients undergoing isolated valve surgery (OR = 1.35, 95% CI 0.61-2.96) or combined CABG and valve surgery (OR = 1.39, 95% CI 0.48-3.99), preoperative statins were not associated with decreased incidence of postoperative renal insufficiency. Age >65 years, preoperative renal insufficiency, history of congestive heart failure, preoperative intra-aortic balloon pump insertion, and total cardiopulmonary bypass time >80 min were also independent predictors associated with increased risk for postoperative renal insufficiency. Conclusions: Preoperative statin therapy was associated with decreased incidence of postoperative renal insufficiency in patients undergoing cardiac surgeries, particularly in patients undergoing isolated CABG.

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