4.1 Article

Statin therapy is associated with reduced total and cardiovascular mortality after coronary artery bypass grafting surgery

Journal

CORONARY ARTERY DISEASE
Volume 19, Issue 8, Pages 619-625

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCA.0b013e3283142607

Keywords

cardiovascular disease mortality; coronary artery bypass grafting surgery; statin therapy; total mortality

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Objective In an observational study, we evaluated the association between postoperative statin therapy and long-term mortality among patients undergoing a first-ever coronary artery bypass grafting (CABG) surgery. Methods In an outpatient clinic setting, we assessed 1869 consecutive patients (age 58.7 +/- 9.6 years; 1657 men), who survived the 1st month after a first-ever CABG, within a 17-year period. Cox proportional hazard analysis was used to calculate the adjusted hazard ratios (adjusting for age, smoking, the presence of hypertension, diabetes mellitus, lipid profile at the time of the procedure, vessel disease, number and kind of grafts used, and concomitant treatment) for patients receiving statin treatment during follow-up and adjusted Kaplan-Meier survival curves were constructed. Results During a 9345 patient-years follow-up, 48% of the patients were on a statin. In a total of 222 deaths, 80.6% were because of cardiovascular causes. Total and cardiovascular mortality were significantly reduced in patients receiving statin therapy [adjusted hazard ratio, 0.48 (95% confidence interval, 0.28-0.82); P=0.007), and 0.43 (95% confidence interval, 0.23-0.80); P=0.007, respectively]. The estimated 16-year Kaplan-Meier survival curves diverged at 2 years and thereafter. Conclusion Taking into account the potential limitations of observational data, statin treatment postoperatively is associated with a 50% reduction in total and cardiovascular mortality in patients undergoing a first-ever CABG. Coron Artery Dis 19:619-625 (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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