VISION: Association Between Pre-Operative Statin Use and CV Events Among Noncardiac Surgery Patients

Preoperative statins are associated with a 17 percent reduction in cardiac complications and a 43 percent reduction in mortality after noncardiac surgery, according to results from the VISION study presented Sept. 1 during ESC Congress 2015 in London and simultaneously published in European Heart Journal.

The multi-center study analyzed data from 15,478 patients (aged 45 years and above) undergoing noncardiac surgery in eight countries around the world. Researchers compared complication rates in patients who received a preoperative statin with patients who did not. The primary endpoint of cardiovascular complications was a composite of all-cause mortality, myocardial injury after noncardiac surgery, or stroke at 30 days. Secondary endpoints were the individual components of the primary endpoint.

Overall results showed preoperative use of statins was associated with a 17 percent lower risk of cardiovascular complications (the primary endpoint). They also found that statins were associated with a lower risk of all-cause mortality (43 percent ), cardiovascular mortality (52 percent) and myocardial injury (14 percent) following noncardiac surgery.

According to study investigators, the VISION study results are consistent with other observational studies and small randomized studies evaluating statins in the perioperative context. "Our findings suggest that statins are a potentially beneficial intervention to prevent cardiovascular complications in patients undergoing noncardiac surgery," said Otavio Berwanger, MD, director of the Research Institute HCor, Hospital do Coração in São Paulo, Brazil. "The findings suggest that statins have the potential to prevent cardiovascular complications in patients undergoing noncardiac surgery."

P.J. Devereaux, MD, from McMaster University, chair of the VISION Steering Committee agrees. "Our finding of reduced major cardiac complications and all-cause mortality after noncardiac surgery in patients taking statins suggest that there may be a new indication for this drug," he said. However, he cautions that the findings "should not be taken as a formal recommendation to use these drugs before surgery," but rather be used to help "inform the design of a large and definitive randomized study to assess the efficacy and safety of statins in the perioperative setting."

Clinical Topics: Dyslipidemia, Nonstatins, Novel Agents, Statins

Keywords: ESC Congress, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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