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A peri‐operative statin update for non‐cardiac surgery. Part I: The effects of statin therapy on atherosclerotic disease and lessons learnt from statin therapy in medical (non‐surgical) patients
Author(s) -
Biccard B. M.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05264.x
Subject(s) - medicine , statin , medical therapy , disease , perioperative , cardiac surgery , physical therapy , atherosclerotic cardiovascular disease , cardiology , intensive care medicine , surgery
Summary The utility of peri‐operative statin therapy is currently considered to be inconclusive. To provide a platform for more meaningful peri‐operative statin literature in the future, this is the first of two review articles evaluating peri‐operative statin therapy. This review examines the predictors of cardiovascular outcome and therapeutic targets which are established in medical (non‐surgical) patients. In patients with stable coronary artery disease at least 4–6 weeks of standard statin therapy are required to realise most of the beneficial cellular and metabolic effects of statin therapy. Low‐density lipoprotein‐cholesterol reduction is associated with improved survival in these patients. In comparison, patients who sustain an acute coronary event require high‐dose statin therapy probably initiated within 24 h with a therapeutic target of C‐reactive protein reduction. Withdrawal of statin therapy results in a rapid return to endothelial dysfunction and amplification of the inflammatory process, which may increase cardiovascular risk.