Beneficial effects of perioperative statins for major pulmonary resection Journal Article


Authors: Amar, D.; Park, B.; Zhang, H.; Shi, W.; Fleisher, M.; Thaler, H. T.; Rusch, V. W.
Article Title: Beneficial effects of perioperative statins for major pulmonary resection
Abstract: OBJECTIVES: Statins improve overall outcomes after noncardiac surgery. The primary aim of the study was to determine whether use of perioperative atorvastatin reduced the rate of postoperative complications in patients undergoing pulmonary resection. METHODS: This was a prospective, randomized, placebo-controlled, double-blind trial of patients undergoing elective pulmonary resection who received atorvastatin (40 mg daily) or placebo beginning 1 week before surgery and continued for 1 week postoperatively. Patient characteristics and postoperative complications were recorded. Plasma inflammatory markers were sampled at baseline, in the post-anesthesia care unit, and on postoperative day 3. Because of difficulty enrolling statin-naive patients, the study was stopped at the interim analysis. RESULTS: Postoperative complications occurred in 16 of 72 patients (22%) receiving placebo and in 8 of 65 patients (12%) receiving atorvastatin (P = .13). For patients undergoing major anatomic resection, there were 24 complications in 15 of 45 placebo-treated patients and 8 complications in 7 of 43 atorvastatin-treated patients (P = .04). Plasma levels of C-reactive protein, tumor necrosis factor-α, and myeloperoxidase did not differ between the 2 treatment arms during the study. CONCLUSIONS: After a 2-week perioperative course of atorvastatin (40 mg) in statin-naïve patients undergoing major pulmonary resection, we found evidence of a reduction in the number of clinically important cardiovascular and pulmonary complications compared with placebo. These promising results merit evaluation in a larger, perhaps multicenter study. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
Keywords: controlled study; treatment outcome; aged; middle aged; united states; prospective study; prospective studies; biological marker; biological markers; lung resection; randomized controlled trial; pneumonectomy; drug administration schedule; inflammation mediators; time; time factors; postoperative complications; blood; new york city; perioperative period; drug administration; pyrroles; double blind procedure; double-blind method; atorvastatin; hydroxymethylglutaryl coenzyme a reductase inhibitor; pyrrole derivative; elective surgery; perioperative care; adverse effects; hydroxymethylglutaryl-coa reductase inhibitors; autacoid; humans; human; male; female; heptanoic acid derivative; elective surgical procedures; heptanoic acids
Journal Title: Journal of Thoracic and Cardiovascular Surgery
Volume: 149
Issue: 6
ISSN: 0022-5223
Publisher: Mosby Elsevier  
Date Published: 2015-06-01
Start Page: 1532
End Page: 1538
Language: English
DOI: 10.1016/j.jtcvs.2014.12.016
PUBMED: 25623903
PROVIDER: scopus
PMCID: PMC4758508
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. Valerie W Rusch
    651 Rusch
  2. Weiji Shi
    111 Shi
  3. David Amar
    105 Amar
  4. Bernard J Park
    155 Park
  5. Martin Fleisher
    236 Fleisher
  6. Howard T Thaler
    191 Thaler
  7. Hao Zhang
    51 Zhang