Perioperative medicine & outcomes
Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery: A cohort study
Authors' conclusion
Adherence to guideline-recommended statin therapy was suboptimal, particularly in women. Statin use was associated with an increased risk of PMI due to T1MI and lT2MI but reduced risk of cardiovascular death and spontaneous MI within 120 days.
Study context
- Population
- High-risk inpatients undergoing major noncardiac surgery eligible for institutional PMI active surveillance and response program, October 2014 to February 20184,227 with class I indication
- Participants
- 8,116 inpatients
- Exposure
- Statins vs No statins
- Statinsn = 2,440
- Outcome
- Adherence to guideline (ESC class I) statin therapy and association with PMI (absolute cTn increase of the 99th percentile above preoperative concentration) and long-term cardiac complications (cardiovascular death and spontaneous MI)
- Follow-up
- First three postoperative days (PMI); 120 days (long-term)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Class I indication for statin therapy
4227 of 8116
52.1%
On statins preoperatively among class I indication
2440 of 4227
57.7%
Adherence to statins, women vs men
46.9 versus 63.9%
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| PMI (T1MI n = 42; lT2MI n = 466) · first three postoperative days | weighted OR 1.15 (95% CI 1.01–1.31) | P = 0.036 | |
| Cardiovascular death and spontaneous MI · 120 daysAfter multivariable adjustment | weighted HR 0.59 (95% CI 0.41–0.86) | P = 0.006 | |
| 0.512Ratio (log scale) |
- PMI (T1MI n = 42; lT2MI n = 466) — PMI overall
- 508 of 4170 (12.2%)
- Cardiovascular death and spontaneous myocardial infarction (MI) — Cardiovascular death and spontaneous MI overall
- 192 (4.6%)
Original publication
Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery: A cohort study. Eur J Anaesthesiol. Published 25 September 2023. doi:10.
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