Association between statins with new-onset cerebral infarction after off-pump coronary artery bypass grafting
10.3760/cma.j.cn112434-20240506-00122
- VernacularTitle:他汀类药物与非体外循环冠状动脉旁路移植术后新发脑梗塞关联性分析
- Author:
Xiaodong ZHANG
1
;
Junran ZHANG
;
Bo YANG
Author Information
1. 临沂市中心医院心脏大血管外科，临沂 276401
- Keywords:
Coronary artery bypass grafting;
Statins;
Cerebral infarction
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(9):553-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore whether the preoperative use of statins in patients with coronary atherosclerotic heart disease (CAD) undergoing off-pump coronary artery bypass grafting (OPCABG) can effectively reduce the risk of postoperative new-onset cerebral infarction.Methods:A retrospective study was conducted on 7 407 CAD patients who underwent OPCABG in the Department of Cardiac Surgery, Beijing Anzhen Hospital, from February 2019 to March 2023. Among them, 5 559 were males and 1 848 were females, with an age range of 26 to 92 years and a median age of 63 years. Hypertension (5 536 cases, 74.7%) was the most common comorbidity, followed by hyperlipidemia (4 261 cases, 57.5%) and type 2 diabetes mellitus (2 941 cases, 39.7%). The patients were divided into the statin group(5 586 cases, 75.4%)and the control group(1 821 cases, 24.6%)based on whether statins were used preoperatively. The inverse probability treatment weighting (IPTW) method was applied to adjust other risk factors, and the odds ratio ( OR) and 95% confidence interval ( CI) were reported to assess the difference in the risk of postoperative new-onset cerebral infarction between the two groups. Results:A total of 346 patients (4.7%) developed new-onset cerebral infarction after OPCABG. After IPTW adjustment, the incidence of cerebral infarction was significantly lower in the statin group compared to the control group (4.3% vs. 6.8%, OR=0.62, 95% CI: 0.53-0.72, P<0.001), and the incidence of postoperative acute kidney injury (AKI) was also lower in the statin group (10.4% vs. 13.4%, OR=0.75, 95% CI: 0.67-0.94, P<0.001). No statistically significant differences were observed between the two groups in terms of postoperative liver injury, postoperative atrial fibrillation, re-thoracotomy rate, use of extracorporeal membrane oxygenation and intra-aortic balloon pump, or in-hospital mortality ( P>0.05). Regardless of whether patients had preoperative hyperlipidemia or whether their low-density lipoprotein cholesterol (LDL-C) levels were within the target range, preoperative statin use effectively reduced the risk of postoperative new-onset cerebral infarction( P<0.05). Conclusion:Statin therapy can significantly reduce the risk of postoperative new-onset cerebral infarction after OPCABG. Preoperative statin use is effective in lowering this risk, regardless of the presence of preoperative hyperlipidemia or whether baseline LDL-C levels are within the target range.
