Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed.Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias.The overall 30-day mortality rate was 2.7\%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95\% confidence interval [CI], 0.32 to 0.89; p=0.001), postoperative cardiac arrhythmias (OR, 0.76; 95\% CI, 0.62 to 0.93; p<0.006), and stroke (OR, 0.54; 95\% CI, 0.32 to 0.92; p=0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (χ2, 4.41; hazard ratio [HR], 1.59; 95\% CI, 1.13 to 2.27; p=0.03), stroke (χ2, 11.42; HR, 2.15; 95\% CI, 1.37 to 3.27; p=0.0007), cardiac arrhythmias (χ2, 19.9; HR, 2.13; 95\% CI, 1.81 to 2.72; p<0.0001), and major adverse cardiac and cerebrovascular events (χ2, 3.74; HR, 1.37; 95\% CI, 0.99 to 1.74; p=0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up.Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations.

Statins improve outcome in isolated heart valve operations: a propensity score analysis of 3,217 patients / Angeloni, Emiliano; G., Melina; U., Benedetto; S., Refice; P., Bianchi; C., Quarto; Sinatra, Riccardo; J. R., Pepper. - In: ANNALS OF THORACIC SURGERY. - ISSN 0003-4975. - STAMPA. - 92:(2011), pp. 68-73. [10.1016/j.athoracsur.2011.03.003]

Statins improve outcome in isolated heart valve operations: a propensity score analysis of 3,217 patients.

ANGELONI, EMILIANO;G. Melina;SINATRA, Riccardo;
2011

Abstract

Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed.Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias.The overall 30-day mortality rate was 2.7\%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95\% confidence interval [CI], 0.32 to 0.89; p=0.001), postoperative cardiac arrhythmias (OR, 0.76; 95\% CI, 0.62 to 0.93; p<0.006), and stroke (OR, 0.54; 95\% CI, 0.32 to 0.92; p=0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (χ2, 4.41; hazard ratio [HR], 1.59; 95\% CI, 1.13 to 2.27; p=0.03), stroke (χ2, 11.42; HR, 2.15; 95\% CI, 1.37 to 3.27; p=0.0007), cardiac arrhythmias (χ2, 19.9; HR, 2.13; 95\% CI, 1.81 to 2.72; p<0.0001), and major adverse cardiac and cerebrovascular events (χ2, 3.74; HR, 1.37; 95\% CI, 0.99 to 1.74; p=0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up.Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/728262
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