Pre-Op Statin Use Ups Insulin Resistance in Heart Surgery

Increased insulin resistance seen in dyslipidemic patients without diabetes taking statins pre-CABG

TUESDAY, July 31 (HealthDay News) -- Patients without diabetes who are taking statins prior to cardiac surgery experience increased insulin resistance compared with those not taking statins, according to a study published online July 24 in Diabetes Care.

To examine the association between preoperative statin therapy and intraoperative insulin sensitivity, Hiroaki Sato, M.D., Ph.D., from the McGill University Health Center in Montreal, and colleagues conducted a prospective, nonrandomized trial involving 120 dyslipidemic patients without diabetes undergoing coronary artery bypass grafting. Patients taking lipophilic statins were assigned to the statin group, while hypercholesterolemic patients not receiving any statins were assigned to the control group. During surgery, insulin sensitivity was assessed by the hyperinsulinemic-normoglycemic clamp technique.

The researchers found that insulin sensitivity gradually decreased during surgery in both groups, with values, on average, 20 percent lower in the statin group than in the control group. The mean blood glucose in the intensive care unit was significantly higher in the statin group than in the control group (153 versus 140 mg/dL). In the statin group the oscillation of blood glucose was also significantly larger. Statin use was independently correlated with intraoperative insulin sensitivity, in multiple regression analysis.

"Preoperative use of lipophilic statins is associated with increased insulin resistance during cardiac surgery in nondiabetic, dyslipidemic patients," the authors conclude.

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