Edgar L. Galiñanes1, Viktor Y. Dombrovskiy2, Shaun Reynolds1, Todd R. Vogel1
1Division of Vascular Surgery, University of Missouri Hospital & Clinics, Columbia, MO; 2UMDNJ, New Brunswick, NJ.
OBJECTIVES: This study evaluated the utilization of preoperative statins and their impact on perioperative outcomes in patients undergoing open (OAR) or endovascular (EVAR) aortic repair.
METHODS: Patients ≥50 years of age with non-ruptured AAA repair were identified in MedPAR files 2007-2008 utilizing ICD-9-CM codes. Preoperative statins use was identified using national drug codes in Part D. Chi-square test, multivariable logistic regression, Kaplan-Meier and Cox regression modeling was performed.
RESULTS: 19,323 patients were identified undergoing AAA repair (14,602 EVAR and 4,721 OAR). 9,913 (50.3%) used statins before surgery. Bivariate analysis demonstrated lower rates of hospital, 30-day, 90-day and 1-year mortality in patients with statins compared to those without after EVAR (1% vs.1.45%, p=0.01; 1.51% vs. 2.3%, p=0.0004; 3.05% vs. 4.66%, p<0.0001; 7.91% vs. 11.56%, p<0.0001, respectively). Multivariable logistic regression adjusting for age, gender, race, comorbidities and procedure demonstrated preoperative statins use was associated with a mortality reduction at 90 days postoperatively (OR=0.80; 95% CI 0.70-0.91, p=0.0014) and 1 year postoperatively (OR= 0.76; 95%CI 0.69-0.84, p=0.0001).
CONCLUSIONS: Only half of patients undergoing AAA repair had preoperative statins. After adjustment, statins were not significantly associated with a benefit until 90 days after surgery suggesting greater long-term mortality benefit. Further prospective studies are needed to assess the benefit of statins in the perioperative period.
AUTHOR DISCLOSURES: V. Y. Dombrovskiy: Nothing to disclose; E. L. Galiñanes: Nothing to disclose; S. Reynolds: Nothing to disclose; T. R. Vogel: Nothing to disclose.
Posted April 2013