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March 1, 2016

Perioperative Statins in Cardiac Surgery and Acute Kidney Injury

Author Affiliations
  • 1School of Medicine, University of Melbourne, Melbourne, Australia
  • 2Department of Intensive Care Unit, Austin Hospital, Melbourne, Australia
JAMA. 2016;315(9):873-874. doi:10.1001/jama.2016.0245

Long-term statin therapy is common among patients and is particularly common among patients who undergo cardiac surgery.1 Among patients undergoing cardiac surgery, perioperative statin therapy is considered desirable because it has been associated with favorable outcomes, such as decreased level of C-reactive protein, lower incidence of atrial fibrillation, and shorter length of hospital stay.2-5 Moreover, such off-label prescribing of statins is indirectly supported by knowledge of their pleiotropic anti-inflammatory effects.6 These effects of statins make any beneficial clinical effect biologically plausible in situations for which activation of the inflammatory pathways is prominent. Accordingly, the combination of such potentially relevant beneficial effects of statins in diseases associated with inflammation and the wide availability, safety, low cost, excellent absorption, and ease of administration of statins have led clinicians to investigate statin treatment for patients with inflammatory states as diverse as sepsis, acute respiratory distress syndrome (ARDS), and cardiac surgery.