Cardio-protective effects of statin therapy in elder patients undergoing coronary artery bypass grafting| JOURNAL OF GERONTOLOGY AND GERIATRICS

Abstract

Background and Aims. Statins exhibit cardiovascular pleiotropic effects for primary and secondary prevention
in patients with coronary artery disease. A debate exists to statin treatment-risk paradox in elderly. The aim of
the study is to investigate the cardio-protective effects of preoperative statin therapy against adverse cardiovascular events after coronary artery bypass grafting (CABG).
Methods. This retrospective study included consecutive patients underwent CABG between January 2010
and December 2015. The study included all patients underwent isolated primary CABG. The age of 65 years
old was used to define elderly. The evaluated endpoints of postoperative adverse outcome included postoperative in-hospital all-cause and cardiac mortality, major adverse cardiovascular events (MACE), myocardial infarction (MI) and stroke. Hazard ratios (HRs) of statin therapy relative to no statin therapy were adjusted for preoperative risk scores, the extent of coronary artery disease (CAD) and administration of other cardiovascular protective medications.
Results. Preoperative statins were prescribed only in 903 patients (16.6%) out of 5437 patients underwent
CABG. Regardless of age, statins reduced the HRs for in-hospital mortality, MACE, MI and stroke after CABG,
with non-significant differences in the interaction of HRs between elder and non-elder patients. The adjusted
HRs did not support the use of high dose intensity in elder patients, especially for the occurrence of MACE.
Conclusions. Elder patients undergoing CABG should not be deprived of any suspected benefit of preoperative
statins to avoid repeated unfavorable events. Further studies are recommended to evaluate the benefits
of high-intensity statins.