Intensity of Statin Therapy in Relation to Myocardial Ischemia, Troponin T Release, and Clinical Cardiac Outcome in Patients Undergoing Major Vascular Surgery

• Published in: Journal of the American College of Cardiology 2007-10, Vol.50 (17), p.1649-1656
• Main Authors: Feringa, Harm H.H., MD, Schouten, Olaf, MD, Karagiannis, Stefanos E., MD, Brugts, Jasper, MD, Elhendy, Abdou, MD, Boersma, Eric, PhD, Vidakovic, Radosav, MD, van Sambeek, Marc R.H.M., MD, Noordzij, Peter G., MD, Bax, Jeroen J., MD, Poldermans, Don, MD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers - metabolism; Cardiology; Cardiology. Vascular system; Cardiovascular; Cholesterol; Cholesterol, LDL - drug effects; Cholesterol, LDL - metabolism; Coronary heart disease; Dose-Response Relationship, Drug; Female; Heart; Heart attacks; Heart Rate - drug effects; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Internal Medicine; Low density lipoprotein; Male; Medical sciences; Multivariate Analysis; Myocardial Ischemia - diagnosis; Myocardial Ischemia - metabolism; Myocarditis. Cardiomyopathies; Outcome Assessment (Health Care); Prospective Studies; Statins; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Troponin T - drug effects; Troponin T - secretion; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular Surgical Procedures
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.06.046

Intensity of Statin Therapy in Relation to Myocardial Ischemia, Troponin T Release, and Clinical Cardiac Outcome in Patients Undergoing Major Vascular Surgery Harm H. H. Feringa, Olaf Schouten, Stefanos E. Karagiannis, Jasper Brugts, Abdou Elhendy, Eric Boersma, Radosav Vidakovic, Marc R.H.M. van Sambeek, Peter G. Noordzij, Jeroen J. Bax, Don Poldermans The cardioprotective effects of statins in patients undergoing major vascular surgery remain not well defined. In a prospective study of 359 patients, statin dose and cholesterol levels were recorded before major vascular surgery. In multivariate analysis, lower low-density lipoprotein cholesterol correlated with lower myocardial ischemia, troponin T release, and 30-day and late cardiac events. Higher statin doses (expressed as percentage of maximum recommended therapeutic dose) correlated with lower myocardial ischemia, troponin T release, and 30-day and late cardiac events, even after adjusting for low-density lipoprotein cholesterol. Significantly higher perioperative heart rate variability was observed in patients with higher statin doses.