Table 1.
Description of Included Studies
| Study (Design) | Statin, No. | No Statin, No. | Type and Dose of Statin, Median (Range) | Timing of Statin Therapy | Study Population | Outcomes | Mean Follow‐up, Y | Conclusion |
|---|---|---|---|---|---|---|---|---|
| Clark et al., 2006 (retrospective cohort)35 | 666 | 50 | 418 Atorva, 10 mg (10–40 mg); 467 Simva, 20 mg (10–60 mg); 71 Lova, 20 mg (20–40 mg); 30 Fluva, 20 mg (20–40 mg); 58 Prava, 20 mg (10–40 mg) | Preoperative, duration NS | Elective valve ± CABG, February 1994–December 2002 | Thirty‐day mortality, MI, stroke, reoperation, composite morbidity | N/A | Lower risk‐adjusted operative mortality (OR: 0.76, CI: 0.62‐0.94) and morbidity (OR: 0.55, CI: 0.32‐0.93) with statin therapy |
| Tabata et al., 2008 (retrospective cohort)38 | 1026 | 363 | 197 Atorva, 10 mg (5–80 mg); 126 Simva, 20 mg (10–80 mg); 21 Prava, 20 mg (10–80 mg); 8 Fluva, 40 mg (20–40 mg); 7 Lova, 20 mg (20–80 mg); 4 rosuvastatin, 20 mg | Statin at time of admission | Elective IVS, January 2002–December 2005 | Thirty‐day mortality, stroke, MI | N/A | Lower operative mortality in patients receiving statin therapy (OR: 0.25, CI: 0.12‐0.54, P = 0.0004); no change in stroke (OR: 0.48, CI: 0.19‐1.22, P = 0.12) or MI (OR: 0.91, CI: 0.43, 1.91, P = 0.8025) |
| Virani et al., 2008 (retrospective cohort)40 | 570 | 255 | Atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatina | NS | Elective IVS, January 2001–December 2006 | Thirty‐day mortality, MACE, MI, stroke | 1.57 | No significant mortality (OR: 0.89, CI: 0.38‐1.96, P = 0.76), MACE (OR: 1.09, CI: 0.61‐1.96, P = 0.76), MI (OR: 1.28, CI: 0.37‐4.41, P = 0.70) or stroke (OR: 1.28, CI: 0.53‐3.10, P = 0.57) benefit with statin therapy |
| Fedoruk et al., 2008 (retrospective cohort)36 | 244 | 203 | NS | Statin at time of preassessment | Consecutive all IVS, July 2004–February 2006 | Thirty‐day mortality, stroke, renal failure | N/A | No significant change in adjusted mortality (OR: 2.70, CI: 0.81‐9.05, P = 0.108); lower adjusted stroke (OR: 5.82, CI: 1.01‐33.59, P = 0.049), renal failure (OR: 2.17, CI: 0.82‐5.70, P = 0.117), and MACE (OR: 2.65, CI: 1.24‐5.66, P = 0.012) with statin therapy |
| Folkeringa et al., 2011 (retrospective cohort)37 | 193 | 79 | NS | Statin ≥1 week preoperative | Consecutive all IVS, July 1996–March 2004 | Thirty‐day mortality AF | N/A | No reduction in AF (OR: 1.49, CI: 0.651‐3.403, P = 0.345) or 30‐day mortality (4% both groups, P = 0.971) with statin therapy |
| Borger et al., 2010 (prospective, observational cohort)34 | 5538 | 4216 | NS | NS | Consecutive IVS ± other, October 2001–May 2008 | MI, LCOS, neurologic injury, renal dysfunction, infection | 3.5 ± 1.9 | No difference in adjusted 30‐day mortality (OR: 0.89, CI: 0.75‐1.06], P = 0.2), long‐term survival (OR: 0.97, CI: 0.88‐1.07, P = 0.6) or combined MI/LCOS/mortality (OR: 0.85, CI: 0.5‐1.45, P = 0.6) with statin therapy |
| Angeloni et al., 2011 (retrospective cohort)33 | 1104 | 1104 | Atorvastatin, simvastatin, rosuvastatin, fluvastatina | NS | Consecutive elective IVS, May 2003–May 2009, 2 centers | Early: mortality, MI, stroke, arrhythmia; Late: mortality, MI, stroke, arrhythmia | 2.25 | Statin therapy independently associated with reduction in operative mortality (OR: 0.48, CI: 0.32‐0.89, P = 0.001), arrhythmia (OR: 0.68, CI: 0.52‐0.96, P = 0.006) and stroke (OR: 0.54, CI: 0.32‐0.92, P = 0.02); lower mortality (P = 0.04), stroke (P = 0.001), arrhythmia (P = 0.03) and MACE (P = 0.0001) at follow‐up with statin treatment; no difference in MI (P = 0.59) |
| Allou et al., 2010 (prospective, observational cohort)32 | 525 | 247 | NS | Statin for ≥2 weeks preoperative | Consecutive elective IVS, November 2005–December 2007 | Mortality, stoke, CS, AKI, sepsis; high‐risk subgroup analysis | N/A | No difference in mortality in whole patient group analysis (P = 0.6); mortality benefit with statins in high‐risk, propensity‐matched subgroup (OR: 0.41, CI: 0.17‐0.97, P = 0.043); no difference in stroke (P = 0.6), CS (P = 0.9), AKI (P = 0.2), sepsis (P = 0.9) or peak TN‐I (P = 0.2) in high‐risk patients receiving statins |
| Vaduganathan et al., 2012 (retrospective cohort)39 | 381 | 381 | NS | NS | All valve ± other, April 2004–April 2010 | Thirty‐day mortality, readmission, late mortality | 2.74 ± 1.88 | Lower 30‐day mortality (1.3% vs 4.2%, P = 0.03) and improved long‐term survival (7.3% vs 11.5%, P = 0.06) with statin therapy; No difference in total postoperative complications (P = 0.56), stroke (P = 1.0) or AF (P = 0.86) between statin and no‐statin groups |
Abbreviations: AF, atrial fibrillation; AKI, acute kidney injury; CABG, coronary artery bypass grafting; CI, 95% confidence interval; CS, cardiogenic shock; IVS, isolated valve surgery; LCOS, low cardiac output syndrome; MACE, major cardiac events; MI, myocardial infarction; N/A, not available; NS, not specified; OR, odds ratio; TN‐I, troponin‐I.
a
Dose not specified.