Abstract
Background This study evaluates whether preoperative statin therapy improves clinical outcomes
in patients referred to coronary artery bypass grafting (CABG) for acute coronary
syndrome (ACS).
Methods A total of 1,151 patients undergoing CABG for ACS were prospectively entered into
the North-Rhine-Westphalia surgical myocardial infarction registry and subdivided
into two groups according to their preoperative statin status (statin naive vs. statin
group). A logistic regression model was employed to analyze the impact of a statin
therapy and dose for the endpoints in-hospital mortality and major adverse cardiac
events (MACE).
Results Demographics, pre- and intraoperative data of the statin-naive group (n = 208; 18%) and statin-treated group (n = 943, 82%) did not differ. In-hospital mortality (12.6 vs. 6.3%, p = 0.002) and MACE rates (22.1 vs. 9.7%, p < 0.001) were significantly higher in statin naive when compared with statin-treated
patients with ACS, respectively. Mevalonic acid revealed that both low- and high-dose
statin treatment was associated to a reduction in in-hospital mortality and MACE,
without a dose-dependent statin effect.
Conclusion Statin therapy in patients with ACS undergoing CABG reduces in a dose-independent
manner in-hospital mortality and MACE.
Keywords
statins - acute coronary syndrome - coronary artery bypass grafting - cardiac surgery
