Thorac cardiovasc Surg 2018; 66(06): 434-441
DOI: 10.1055/s-0037-1602257
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Statin Therapy in Patients Undergoing Coronary Artery Bypass Grafting for Acute Coronary Syndrome

Oliver J. Liakopoulos
1  Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Germany
,
Elmar W. Kuhn
1  Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Germany
,
Ingo Slottosch
1  Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Germany
,
Matthias Thielmann
2  Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University of Duisburg-Essen, Germany
,
Daniel Wendt
2  Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University of Duisburg-Essen, Germany
,
Kathrin Kuhr
3  Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
,
Heinz Jakob
2  Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University of Duisburg-Essen, Germany
,
Thorsten Wahlers
1  Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Germany
,
on behalf of the North-Rhine-Westphalia Study Group› Author Affiliations
Further Information

Publication History

12 January 2017

13 March 2017

Publication Date:
20 April 2017 (eFirst)

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.