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Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery: a randomized, placebo-controlled trial

 Jin Ha Park  ;  Jae-Kwang Shim  ;  Jong-Wook Song  ;  Sarah Soh  ;  Young-Lan Kwak 
 Intensive Care Medicine, Vol.42(9) : 1398-1407, 2016 
Journal Title
 Intensive Care Medicine 
Issue Date
Acute Kidney Injury/blood ; Acute Kidney Injury/etiology ; Acute Kidney Injury/prevention & control* ; Administration, Oral ; Aged ; Atorvastatin Calcium/administration & dosage* ; Biomarkers/blood ; Cardiopulmonary Bypass/adverse effects* ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage* ; Male ; Middle Aged ; Perioperative Period ; Postoperative Complications/blood ; Postoperative Complications/prevention & control* ; Prospective Studies
Acute kidney injury ; Cardiac surgery ; Cardiopulmonary bypass ; Statins
PURPOSE: Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have the potential to reduce acute kidney injury (AKI) after cardiac surgery through their pleiotropic properties. Here we studied the preventive effect of atorvastatin on AKI after valvular heart surgery. METHODS: Two-hundred statin-na?ve patients were randomly allocated to receive either statin or placebo. Atorvastatin was administered orally to the statin group according to a dosage schedule (80 mg single dose on the evening prior to surgery; 40 mg on the morning of surgery; three further doses of 40 mg on the evenings of postoperative days 0, 1, and 2). AKI incidence was assessed during the first 48 postoperative hours on the basis of Acute Kidney Injury Network criteria. RESULTS: The incidence of AKI was similar in the statin and control groups (21 vs. 26 %, respectively, p = 0.404). Biomarkers of renal injury including plasma neutrophil gelatinase-associated lipocalin and interleukin-18 were also similar between the groups. The statin group required significantly less norepinephrine and vasopressin during surgery, and fewer patients in the statin group required vasopressin. There were no significant differences in postoperative outcomes. CONCLUSIONS: Acute perioperative statin treatment was not associated with a lower incidence of AKI or improved clinical outcome in patients undergoing valvular heart surgery. (ClinicalTrials.gov NCT01909739).
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
곽영란(Kwak, Young Lan) ORCID logo https://orcid.org/0000-0002-2984-9927
박진하(Park, Jin Ha) ORCID logo https://orcid.org/0000-0002-1398-3304
소사라(Soh, Sa Rah) ORCID logo https://orcid.org/0000-0001-5022-4617
송종욱(Song, Jong Wook) ORCID logo https://orcid.org/0000-0001-7518-2070
심재광(Shim, Jae Kwang) ORCID logo https://orcid.org/0000-0001-9093-9692
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