Statins improve outcome in isolated heart valve operations: A propensity score analysis of 3,217 patients

Emiliano Angeloni, Giovanni Melina, Umberto Benedetto, Simone Refice, Paolo Bianchi, Cesare Quarto, Riccardo Sinatra, John R. Pepper

Research output: Contribution to journalArticle

Abstract

Background: Whether statins can improve postoperative outcome in patients without coronary artery disease undergoing heart valve operations was assessed. Methods: Data for 3,217 patients undergoing isolated valve procedures at 2 institutions between May 2003 and May 2009 were reviewed. Clinical follow-up was completed. Two propensity-matched cohorts of 1,104 patients each were identified. Multivariable regression and Kaplan-Meyer survival analysis were performed to investigate risk factors correlated with death, stroke, myocardial infarction, and cardiac arrhythmias. Results: The overall 30-day mortality rate was 2.7%, and 2,096 of 2,149 hospital survivors were alive at a median follow-up of 27 months. Preoperative statin treatment was independently associated with a significant reduction in the risk of hospital death (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32 to 0.89; p = 0.001), postoperative cardiac arrhythmias (OR, 0.76; 95% CI, 0.62 to 0.93; p <0.006), and stroke (OR, 0.54; 95% CI, 0.32 to 0.92; p = 0.02) but was not independently associated with a reduced risk of postoperative myocardial infarction. At follow-up, Kaplan-Meyer survival analysis showed statistically significant lower rates of mortality (χ2, 4.41; hazard ratio [HR], 1.59; 95% CI, 1.13 to 2.27; p = 0.03), stroke (χ2, 11.42; HR, 2.15; 95% CI, 1.37 to 3.27; p = 0.0007), cardiac arrhythmias (χ2, 19.9; HR, 2.13; 95% CI, 1.81 to 2.72; p <0.0001), and major adverse cardiac and cerebrovascular events (χ2, 3.74; HR, 1.37; 95% CI, 0.99 to 1.74; p = 0.05) in patients receiving statin treatment. No statistically significant difference was found between groups in myocardial infarction incidence at follow-up. Conclusions: Statin therapy is associated with a lower rate of adverse cardiovascular events after isolated heart valve operations.

Original languageEnglish
Pages (from-to)68-73
Number of pages6
JournalAnnals of Thoracic Surgery
Volume92
Issue number1
DOIs
Publication statusPublished - Jul 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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    Angeloni, E., Melina, G., Benedetto, U., Refice, S., Bianchi, P., Quarto, C., Sinatra, R., & Pepper, J. R. (2011). Statins improve outcome in isolated heart valve operations: A propensity score analysis of 3,217 patients. Annals of Thoracic Surgery, 92(1), 68-73. https://doi.org/10.1016/j.athoracsur.2011.03.003