Influence of Preoperative Lipid-Lowering Therapy on Postoperative Outcome in Patients Undergoing Coronary Artery Bypass Grafting

Brian D. Powell, Kevin A. Bybee, Uma Valeti, Randal J. Thomas, Stephen L. Kopecky, Charles J. Mullany, R. Scott Wright

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Statin therapy has recently been shown to decrease adverse perioperative events in patients undergoing vascular surgery. The potential beneficial effect of lipid-lowering therapy in patients undergoing coronary artery bypass grafting (CABG) is not well known. This was an observational analysis of 4,739 patients who underwent first-time isolated CABG at a single institution from 1995 to 2001. Patients were categorized into 2 groups based on treatment with a lipid-lowering agent within 30 days before surgery. Univariate and multivariate analyses were used to determine the association between lipid-lowering therapy and survival to hospital discharge. Patients in the lipid-lowering group (n = 2,334) tended to be younger (mean age 66 ± 10 vs 68 ± 10 years), were more likely to be diabetic (31% vs 28%), and on β blockers (77% vs 70%) than patients in the nonlipid-lowering group (n = 2,405). In-hospital mortality was significantly lower in the lipid-lowering group than in the nonlipid-lowering therapy group (1.4% vs 2.2%, odds ratio 0.62, 95% confidence interval 0.40 to 0.96, p = 0.03). A multivariable model demonstrated a loss of statistical significance for the effect of lipid-lowering therapy on in-hospital mortality (adjusted odds ratio 0.83, 95% confidence interval 0.5 to 1.37, p = 0.46). In conclusion, preoperative use of lipid-lowering therapy in patients undergoing CABG appears safe and is associated with improved survival to hospital discharge compared with patients not receiving lipid-lowering therapy. However, patient risk factors and other cardioprotective medication use associated with the use of preoperative lipid-lowering therapy appear to explain the association with improved survival.

Original languageEnglish (US)
Pages (from-to)785-789
Number of pages5
JournalAmerican Journal of Cardiology
Volume99
Issue number6
DOIs
StatePublished - Mar 15 2007

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Coronary Artery Bypass
Lipids
Therapeutics
Hospital Mortality
Survival
Odds Ratio
Confidence Intervals
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Group Psychotherapy
Ambulatory Surgical Procedures
Blood Vessels
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of Preoperative Lipid-Lowering Therapy on Postoperative Outcome in Patients Undergoing Coronary Artery Bypass Grafting. / Powell, Brian D.; Bybee, Kevin A.; Valeti, Uma; Thomas, Randal J.; Kopecky, Stephen L.; Mullany, Charles J.; Wright, R. Scott.

In: American Journal of Cardiology, Vol. 99, No. 6, 15.03.2007, p. 785-789.

Research output: Contribution to journalArticle

Powell, Brian D. ; Bybee, Kevin A. ; Valeti, Uma ; Thomas, Randal J. ; Kopecky, Stephen L. ; Mullany, Charles J. ; Wright, R. Scott. / Influence of Preoperative Lipid-Lowering Therapy on Postoperative Outcome in Patients Undergoing Coronary Artery Bypass Grafting. In: American Journal of Cardiology. 2007 ; Vol. 99, No. 6. pp. 785-789.
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abstract = "Statin therapy has recently been shown to decrease adverse perioperative events in patients undergoing vascular surgery. The potential beneficial effect of lipid-lowering therapy in patients undergoing coronary artery bypass grafting (CABG) is not well known. This was an observational analysis of 4,739 patients who underwent first-time isolated CABG at a single institution from 1995 to 2001. Patients were categorized into 2 groups based on treatment with a lipid-lowering agent within 30 days before surgery. Univariate and multivariate analyses were used to determine the association between lipid-lowering therapy and survival to hospital discharge. Patients in the lipid-lowering group (n = 2,334) tended to be younger (mean age 66 ± 10 vs 68 ± 10 years), were more likely to be diabetic (31{\%} vs 28{\%}), and on β blockers (77{\%} vs 70{\%}) than patients in the nonlipid-lowering group (n = 2,405). In-hospital mortality was significantly lower in the lipid-lowering group than in the nonlipid-lowering therapy group (1.4{\%} vs 2.2{\%}, odds ratio 0.62, 95{\%} confidence interval 0.40 to 0.96, p = 0.03). A multivariable model demonstrated a loss of statistical significance for the effect of lipid-lowering therapy on in-hospital mortality (adjusted odds ratio 0.83, 95{\%} confidence interval 0.5 to 1.37, p = 0.46). In conclusion, preoperative use of lipid-lowering therapy in patients undergoing CABG appears safe and is associated with improved survival to hospital discharge compared with patients not receiving lipid-lowering therapy. However, patient risk factors and other cardioprotective medication use associated with the use of preoperative lipid-lowering therapy appear to explain the association with improved survival.",
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