- is REASONABLE in patients undergoing vascular surgery,
- and CONSIDERED in patients with clinical indications of need statin therapy with or without surgery.
- Studies have shown that patients receiving statin therapy at the time of surgery have lower rates of perioperative cardiac events and lower mortality, with reductions in risk 30% - 80% compared with patients not receiving statins.
Lindenauer PK, Pekow P, Wang K, Gutierrez B, Benjamin EM. Lipid-Lowering Therapy and In-Hospital Mortality Following Major Noncardiac Surgery. JAMA. 2004;291
O’Neil-Callahan, Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery: The Statins for Risk Reduction in Surgery (StaRRS) study, JACA, 2005.Vol 45 issue 3
- The mechanism of benefit of statin therapy is unclear and may be related to pleiotropic effects (reducing inflammation, and stabilizing plaques) as well as cholesterol lowering effects.
- In patients meeting indications for statin therapy, starting statin therapy perioperatively may also be an opportunity to impact long-term health.
- Continue at usual dosage for patients currently on a statin
- e.g. atorvastatin 20 mg po q24hr
- Best time to start unknown. However, studies suggest possibly 30 days prior to surgery, but has been used in emergent surgeries with decrease in major cardiovascular events.