Statin Use Reduces Mortality in Patients Who Develop Major Complications After Transcarotid Artery Revascularization
Author Type(s)
Faculty, Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.avsg.2021.12.023
Journal Title
Annals of Vascular Surgery
Department
Surgery
Abstract
INTRODUCTION AND OBJECTIVES: The impact of preoperative statin use in patients undergoing transcarotid artery revascularization (TCAR) is not well established. The aim of this study was to evaluate the effect of statin on postoperative outcomes after TCAR. METHODS: Vascular Quality Initiative registry (2012-2020) was queried for patients undergoing TCAR. Patient demographics, perioperative characteristics and 30-day outcomes were compared between patients treated with and without statins at least 30 days preoperatively. Multivariable logistic regression models were used to estimate the effect of statins on postoperative outcomes. RESULTS: A total of 15,797 patients underwent TCAR, and 10,116 (64%) were males. 14,152 (89.6%) patients were on statin preoperatively (Table). There was higher incidence of both prior ipsilateral stroke (17.2% vs 13.5%; P<.001) and recent ipsilateral stroke (≤ 30 days; 7.1% vs 5.6%; P=.02) in the statin group. Perioperative stroke and major adverse cardiac event (MACE; myocardial infarction, congestive heart failure and dysrhythmia) occurred in 1.5% and 2.4% among patients on statins and 1.4% and 2.3% among those not on statins, respectively. After adjusting for potential confounders and baseline differences, statin use was associated with 62% reduction in the odds of mortality (OR 0.38; 95% CI, 0.19-0.99; P=.047) in patients who developed a perioperative stroke or MACE after TCAR (Figure). CONCLUSIONS: Statin use was associated with a significant reduction in postoperative mortality in patients who develop a stroke or MACE after TCAR. Therefore, strict adherence to statin is strongly recommended, particularly in patients who may be at high risk of major postoperative complications.[Formula presented]
Recommended Citation
Chang, H., Zeeshan, M., Rockman, C. B., Veith, F. J., Laskowski, I., Kashyap, V. S., Jacobowitz, G. R., Garg, K., Sadek, M., & Maldonado, T. S. (2022). Statin Use Reduces Mortality in Patients Who Develop Major Complications After Transcarotid Artery Revascularization. Annals of Vascular Surgery, 79, 382-383. https://doi.org/10.1016/j.avsg.2021.12.023
