Cholesterol-lowering drugs are important, especially on the day of coronary bypass surgery.
Patients on statins should not stop taking the cholesterol-lowering medication before heart surgery — even on the day of surgery, according to an article posted online today in The Annals of Thoracic Surgery. The new research shows that continuation of statins may significantly improve survival following the operation.
Key findings include stopping statin medication even one day before CABG surgery may significantly affect patient outcomes, statin dose of up to 20mg was shown to offer the best chance for patient survival after CABG surgery, and patients who are scheduled for CABG surgery should consult their doctors about statin use.
“Patients frequently forget to take their pills on the day of surgery, or they’ve been told to stop certain medications,” said Wei Pan, MD, a cardiovascular anesthesiologist at the Texas Heart Institute in Houston. “This study shows that not taking your statin for even one day before cardiac surgery may increase your risk of death after surgery. Based on our findings, we would advise patients to continue taking their statin medication all the way up to and including the day of surgery.”
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Dr. Pan and colleagues examined data from 3,025 patients who underwent coronary artery bypass grafting (CABG) between July 2005 and May 2011 at the Texas Heart Institute, Catholic Health Initiatives St. Luke’s Health-Baylor St. Luke’s Medical Center to determine the optimal dose and timing of preoperative statin administration.
For patients who were admitted to the hospital on the day of operation, the researchers reviewed preoperative medication questionnaires to determine the timing and dosage of the statin administered. For those who were inpatients, nursing administration records were reviewed.
The researchers found that for the 59% of patients (1,788) who had taken statins 24 hours or less before their operation, the incidence of 30-day all-cause mortality (estimate of deaths from any cause within 30 days of surgery) was 1.7%. That compares to 2.9% for those who took statins 24 to 72 hours preoperatively and 3.8% for those who did not take statins or whose last dose was more than 72 hours before the surgery.