For CABG, MI risk not decreased by pre-procedure drugs, but atrial fibrillation risk lower
THURSDAY, Sept. 2 (HealthDay News) -- Administration of a pre-procedural statin drug significantly reduces myocardial infarction after both percutaneous coronary intervention (PCI) and non-cardiac surgery, and also lowers the risk of atrial fibrillation after coronary artery bypass grafting (CABG), according to research published online Aug. 30 in the Journal of the American College of Cardiology to coincide with the European Society of Cardiology Congress, held from Aug. 28 to Sept. 1 in Stockholm, Sweden.
David E. Winchester, M.D., of the University of Florida in Gainesville, and colleagues conducted a meta-analysis of randomized trials of pre-procedural statin therapy to reduce peri-procedural adverse events. Twenty-one trials, which included 4,805 patients, met the inclusion criteria. The invasive procedures included in the analysis were PCI, CABG, and non-cardiac surgery.
The researchers found an overall significantly decreased risk of myocardial infarction with pre-procedural statin use (risk ratio, 0.57); however, when considered separately for specific procedures, this decreased risk was significant only for PCI and non-cardiac surgery. For CABG patients receiving pre-procedural statins, there was a significantly decreased risk of postoperative atrial fibrillation (risk ratio, 0.54). All-cause mortality risk was reduced with pre-procedural statin use, but the decrease was not significant.
"The available evidence creates a convincing argument for statin treatment before coronary procedures," write the authors of an accompanying editorial. "Given the strong biological rationale and the sum of the clinical data, no patient should undergo coronary procedures without statin therapy unless clear contraindications exist. Indeed, it is time to consider a new indication for an old friend."
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