TY - JOUR
T1 - Incidence of perioperative myocardial infarction and of 2-year mortality in 577 elderly patients undergoing noncardiac vascular surgery treated with and without statins
AU - Desai, Harit
AU - Aronow, Wilbert S.
AU - Ahn, Chul
AU - Gandhi, Kaushang
AU - Amin, Harshad
AU - Lai, Hoang M.
AU - Tsai, Fausan S.
AU - Sharma, Mala
AU - Babu, Sateesh
N1 - Funding Information:
We investigated in an observational single center study the incidences of perioperative myocardial infarction, all-cause mortality, and the combined end points of perioperative myocardial infarction or mortality during 2 years of follow-up in 577 unselected consecutive patients undergoing major noncardiac vascular surgery treated with and without statins. Mean follow-up was 2 years. All patients who underwent noncardiac vascular surgery between January 1, 2004 through December 31, 2007 were included in the study. Data were recorded prospectively. This study was approved by the New York Medical College Institutional Review Board and by the Institutional Review Board of Westchester Medical Center. The patients treated with statins received statins prior to surgery, perioperatively, and for the entire follow-up period. None of the patients treated with statins received any other lipid-lowering drugs. The 192 patients with dyslipidemia not treated with any lipid-lowering therapy were not treated with statins because the physicians treating these patients did not use statins or other lipid-lowering therapy for treating their patients with dyslipidemia or vascular disease. None of the patients not receiving statins were intolerant to statins. Student's . t -tests were used to compare continuous variables between patients treated with and without statins. X 2 -test and Fisher's exact test were used to compare dichotomous variables between patients treated with and without statins. Stepwise Cox regression analysis was performed for perioperative myocardial infarction or time to death using the variables listed in Table 1 3
PY - 2010/9
Y1 - 2010/9
N2 - Of 577 patients, mean age 74 years, undergoing noncardiac vascular surgery, 300 (52%) had carotid endarterectomy, 179 (31%) had lower extremity revascularization, and 98 (17%) had abdominal aortic aneurysm repair. Of the 577 patients, 302 (52%) were treated with statins. Perioperative myocardial infarction (MI) occurred in 18 of 302 patients (6%) treated with statins and in 38 of 275 patients (14%) not treated with statins (p=0.001). Two-year mortality occurred in 18 of 302 patients (6%) treated with statins and in 43 of 275 patients (16%) not treated with statins (p=0.0002). Perioperative MI or mortality occurred in 34 of 302 patients (11%) treated with statins and in 74 of 275 patients (27%) not treated with statins (p<0.0001). Stepwise Cox regression analysis showed that significant independent prognostic factors for perioperative MI or death were use of statins (risk ratio. =RR. =0.43, p<0.0001), use of beta blockers (RR. =0.55, p=0.002), carotid endarterectomy (RR. =0.60, p=0.009), and diabetes (RR. =1.5, p=0.045). In conclusion, patients undergoing noncardiac vascular surgery treated with statins had a 57% less chance of having perioperative MI or death at 2-year follow-up after controlling for other variables.
AB - Of 577 patients, mean age 74 years, undergoing noncardiac vascular surgery, 300 (52%) had carotid endarterectomy, 179 (31%) had lower extremity revascularization, and 98 (17%) had abdominal aortic aneurysm repair. Of the 577 patients, 302 (52%) were treated with statins. Perioperative myocardial infarction (MI) occurred in 18 of 302 patients (6%) treated with statins and in 38 of 275 patients (14%) not treated with statins (p=0.001). Two-year mortality occurred in 18 of 302 patients (6%) treated with statins and in 43 of 275 patients (16%) not treated with statins (p=0.0002). Perioperative MI or mortality occurred in 34 of 302 patients (11%) treated with statins and in 74 of 275 patients (27%) not treated with statins (p<0.0001). Stepwise Cox regression analysis showed that significant independent prognostic factors for perioperative MI or death were use of statins (risk ratio. =RR. =0.43, p<0.0001), use of beta blockers (RR. =0.55, p=0.002), carotid endarterectomy (RR. =0.60, p=0.009), and diabetes (RR. =1.5, p=0.045). In conclusion, patients undergoing noncardiac vascular surgery treated with statins had a 57% less chance of having perioperative MI or death at 2-year follow-up after controlling for other variables.
KW - Abdominal aortic aneurysm repair
KW - Beta blockers
KW - Carotid endarterectomy
KW - Lower extremity revascularization
KW - Statins
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U2 - 10.1016/j.archger.2009.09.042
DO - 10.1016/j.archger.2009.09.042
M3 - Article
C2 - 19819571
AN - SCOPUS:77955269145
VL - 51
SP - 149
EP - 151
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
SN - 0167-4943
IS - 2
ER -