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Effects of chronic statin use on 30-day major adverse cardiac and cerebrovascular events after thoracic endovascular aortic repair

 Sung Y. HAM  ;  Suk W. SONG  ;  Sang B. NAM  ;  Soo J. PARK  ;  Sijin KIM  ;  Young SONG 
 JOURNAL OF CARDIOVASCULAR SURGERY , Vol.59(6) : 836-843, 2018 
Journal Title
Issue Date
Acute Disease ; Acute Kidney Injury/chemically induced ; Aged ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/surgery* ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/mortality ; Aortic Diseases/surgery* ; Blood Vessel Prosthesis Implantation/adverse effects* ; Blood Vessel Prosthesis Implantation/mortality ; Cerebrovascular Disorders/diagnosis ; Cerebrovascular Disorders/etiology ; Cerebrovascular Disorders/mortality ; Cerebrovascular Disorders/prevention & control* ; Drug Administration Schedule ; Endovascular Procedures/adverse effects* ; Endovascular Procedures/mortality ; Female ; Heart Diseases/diagnosis ; Heart Diseases/etiology ; Heart Diseases/mortality ; Heart Diseases/prevention & control* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Male ; Middle Aged ; Protective Factors ; Retrospective Studies ; Risk Factors ; Syndrome ; Treatment Outcome
BACKGROUND: Cardiac and cerebrovascular complications are major causes of adverse outcomes following thoracic endovascular aortic repair (TEVAR). The benefits of statins have been established, but little is known about their impact on patients undergoing TEVAR. We investigated whether chronic statin use protected against early postoperative major adverse cardiac and cerebrovascular events (MACCEs) after TEVAR.

METHODS: We retrospectively reviewed 211 patients who underwent TEVAR between February 2013 and March 2017 classified into two groups, those with acute aortic syndrome (AAS, N.=79) and those without (non-AAS, N.=132). Patients were subdivided according to preoperative statin therapy for ≥3 months or not. The primary endpoint was 30-day MACCE, defined as myocardial infarction, stroke, arrhythmia, cardiovascular death, or cerebrovascular death. Acute kidney injury (AKI) occurrence within 48 hours was also evaluated. Multivariate logistic regression analysis was performed to identify independent risk factors for MACCEs and AKI.

RESULTS: Incidence of MACCEs (1% vs. 11%, P=0.019) was significantly lower in the statin group than in the no-statin group in non-AAS patients. Multivariate logistic regression analysis revealed statin use (odds ratio 0.85, 95% confidence interval 0.01-0.95, P=0.046) as an independent predictor for MACCE in non-AAS patients. The AKI incidence was significantly higher in the statin group than in the no-statin group in AAS patients (44% vs. 15%, P=0.018).

CONCLUSIONS: In patients undergoing TEVAR, chronic statin use was associated with reduced 30-day MACCEs in non-AAS patients, but not in AAS patients. It might rather be associated with increased risk of AKI in AAS patients.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Sang Beom(남상범) ORCID logo https://orcid.org/0000-0002-9704-1866
Park, Soo Jung(박수정) ORCID logo https://orcid.org/0000-0003-2963-1394
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
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