Perioperative use of statins in noncardiac surgery

Review

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Authors: YC Chan, SW Cheng, MG Irwin

Published Date March 2008 Volume 2008:4(1) Pages 75 - 81

DOI: http://dx.doi.org/10.2147/VHRM.S1915

YC Chan¹, SW Cheng¹, MG Irwin²

¹Division of Vascular Surgery and ²Anaesthesiology, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Hong Kong, China

Background: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) can significantly decrease cardiovascular mortality and morbidity, irrespective of the patients’ cholesterol status. This paper reviews the effects of perioperative statin therapy in patients undergoing noncardiac surgery.

Method: A systematic literature review was undertaken of all published literature on this subject using Medline and cross-referenced. All published relevant papers on the perioperative use of statins were used.

Results: Perioperative statin therapy is associated with a lower perioperative morbidity and mortality in patients undergoing elective or emergency surgery. The effects are due to a combination of lipid-lowering and pleiotropic properties of statins.

Conclusion: Ideally a large scale multi-centre randomized controlled trial of perioperative statin therapy should be performed but this may be difficult to conduct since there is already overwhelming evidence in the literature to suggest perioperative cardiovascular protective properties. Statins may still be under-prescribed in surgical patients.

Keywords: perioperative, cardiac complications, morbidity, mortality, outcome, statins, vascular, noncardiac surgery