Papathanasiou Athanasios, Toumpoulis Ioannis K, Milionis Haralampos J, Kalantzi Kallirroi, Katsouras Christos S, Goudevenos John
Department of Cardiology, School of Medicine, University of Ioannina, Ioannina, Greece.
Coron Artery Dis. 2008 Dec;19(8):619-25. doi: 10.1097/MCA.0b013e3283142607.
In an observational study, we evaluated the association between postoperative statin therapy and long-term mortality among patients undergoing a first-ever coronary artery bypass grafting (CABG) surgery.
In an outpatient clinic setting, we assessed 1869 consecutive patients (age 58.7+/-9.6 years; 1657 men), who survived the 1st month after a first-ever CABG, within a 17-year period. Cox proportional hazard analysis was used to calculate the adjusted hazard ratios (adjusting for age, smoking, the presence of hypertension, diabetes mellitus, lipid profile at the time of the procedure, vessel disease, number and kind of grafts used, and concomitant treatment) for patients receiving statin treatment during follow-up and adjusted Kaplan-Meier survival curves were constructed.
During a 9345 patient-years follow-up, 48% of the patients were on a statin. In a total of 222 deaths, 80.6% were because of cardiovascular causes. Total and cardiovascular mortality were significantly reduced in patients receiving statin therapy [adjusted hazard ratio, 0.48 (95% confidence interval, 0.28-0.82); P=0.007), and 0.43 (95% confidence interval, 0.23-0.80); P=0.007, respectively]. The estimated 16-year Kaplan-Meier survival curves diverged at 2 years and thereafter.
Taking into account the potential limitations of observational data, statin treatment postoperatively is associated with a 50% reduction in total and cardiovascular mortality in patients undergoing a first-ever CABG.
在一项观察性研究中，我们评估了首次接受冠状动脉搭桥术（CABG）的患者术后他汀类药物治疗与长期死亡率之间的关联。
在门诊环境中，我们评估了17年间首次接受CABG术后存活1个月的1869例连续患者（年龄58.7±9.6岁；男性1657例）。采用Cox比例风险分析计算随访期间接受他汀类药物治疗患者的调整风险比（调整年龄、吸烟、高血压、糖尿病、手术时的血脂水平、血管疾病、所用移植物的数量和种类以及伴随治疗），并构建调整后的Kaplan-Meier生存曲线。
在9345患者年的随访期间，48%的患者服用他汀类药物。在总共222例死亡病例中，80.6%是由心血管原因导致的。接受他汀类药物治疗的患者总死亡率和心血管死亡率显著降低[调整风险比分别为0.48（95%置信区间，0.28 - 0.82）；P = 0.007]和0.43（95%置信区间，0.23 - 0.80）；P = 0.007]。估计的16年Kaplan-Meier生存曲线在2年后出现分歧。
考虑到观察性数据的潜在局限性，首次接受CABG的患者术后他汀类药物治疗与总死亡率和心血管死亡率降低50%相关。
