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Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm

BACKGROUND: There is a lack of evidence for the association between intensive statin therapy and outcomes following vascular surgery. The aim of this study was to evaluate the association between perioperative statin intensity and in‐hospital mortality following open abdominal aortic aneurysm (AAA)...

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Autores principales: Alshaikh, H. N., Bohsali, F., Gani, F., Nejim, B., Malas, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254010/
https://www.ncbi.nlm.nih.gov/pubmed/30511041
http://dx.doi.org/10.1002/bjs5.94
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author Alshaikh, H. N.
Bohsali, F.
Gani, F.
Nejim, B.
Malas, M.
author_facet Alshaikh, H. N.
Bohsali, F.
Gani, F.
Nejim, B.
Malas, M.
author_sort Alshaikh, H. N.
collection PubMed
description BACKGROUND: There is a lack of evidence for the association between intensive statin therapy and outcomes following vascular surgery. The aim of this study was to evaluate the association between perioperative statin intensity and in‐hospital mortality following open abdominal aortic aneurysm (AAA) repair. METHODS: Patients undergoing open AAA repair between 2009 and 2015 were identified from the Premier Healthcare Database. Statin use was classified into low, moderate and high intensity, based on American College of Cardiology/American Heart Association guidelines. Supratherapeutic intensity was defined as doses higher than the recommended guidelines. Multivariable logistic regression analyses were undertaken to assess the association between statin intensity and postoperative major adverse events and in‐hospital mortality. RESULTS: Of 6497 patients undergoing open AAA repair, 3217 (49·5 per cent) received perioperative statin. Statin users were more likely to present with three or more co‐morbidities than non‐users (26·5 versus 21·8 per cent; P < 0·001). Unadjusted postoperative mortality was significantly lower in statin users (2·6 versus 6·3 per cent; P < 0·001); however, there was no difference in the risk of developing major adverse events. Multivariable analysis showed that statin use was associated with lower odds of death (odds ratio 0·41, 95 per cent c.i. 0·31 to 0·54). Moderate, high and supratherapeutic statin intensities were not associated with lower odds of death or major adverse events compared with low‐intensity statin therapy. CONCLUSION: Statin use is associated with lower odds of death in hospital following open AAA repair. High‐intensity statins were not associated with lower morbidity or mortality.
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spelling pubmed-62540102018-12-03 Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm Alshaikh, H. N. Bohsali, F. Gani, F. Nejim, B. Malas, M. BJS Open Original Articles BACKGROUND: There is a lack of evidence for the association between intensive statin therapy and outcomes following vascular surgery. The aim of this study was to evaluate the association between perioperative statin intensity and in‐hospital mortality following open abdominal aortic aneurysm (AAA) repair. METHODS: Patients undergoing open AAA repair between 2009 and 2015 were identified from the Premier Healthcare Database. Statin use was classified into low, moderate and high intensity, based on American College of Cardiology/American Heart Association guidelines. Supratherapeutic intensity was defined as doses higher than the recommended guidelines. Multivariable logistic regression analyses were undertaken to assess the association between statin intensity and postoperative major adverse events and in‐hospital mortality. RESULTS: Of 6497 patients undergoing open AAA repair, 3217 (49·5 per cent) received perioperative statin. Statin users were more likely to present with three or more co‐morbidities than non‐users (26·5 versus 21·8 per cent; P < 0·001). Unadjusted postoperative mortality was significantly lower in statin users (2·6 versus 6·3 per cent; P < 0·001); however, there was no difference in the risk of developing major adverse events. Multivariable analysis showed that statin use was associated with lower odds of death (odds ratio 0·41, 95 per cent c.i. 0·31 to 0·54). Moderate, high and supratherapeutic statin intensities were not associated with lower odds of death or major adverse events compared with low‐intensity statin therapy. CONCLUSION: Statin use is associated with lower odds of death in hospital following open AAA repair. High‐intensity statins were not associated with lower morbidity or mortality. John Wiley & Sons, Ltd 2018-09-06 /pmc/articles/PMC6254010/ /pubmed/30511041 http://dx.doi.org/10.1002/bjs5.94 Text en © 2018 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of the BJS Society Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Alshaikh, H. N.
Bohsali, F.
Gani, F.
Nejim, B.
Malas, M.
Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title_full Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title_fullStr Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title_full_unstemmed Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title_short Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
title_sort statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254010/
https://www.ncbi.nlm.nih.gov/pubmed/30511041
http://dx.doi.org/10.1002/bjs5.94
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