Statins and early clinical outcome after coronary artery bypass grafting

Lipid-lowering therapy with statins prevents progression of atherosclerotic coronary artery and vein graft disease, decreases cardiovascular events and improves long-term clinical outcome after coronary artery bypass grafting (CABG). The impact of preoperative statin therapy on the early postoperative outcome of the coronary bypass patient remains unclear. The Mayo Clinic group reports a 0.8% absolute and 36% relative decrease of in-hospital mortality in patients receiving lipid-lowering therapy prior to elective CABG. However, after adjusting for preoperative risk factors and medications, lipid-lowering therapy was not independently associated with improved survival after surgery. This finding contradicts evidence suggesting that preoperative statin therapy favorably impacts early mortality after CABG and raises questions regarding current recommendations for routine statin pretreatment before surgery.