Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
Curr Vasc Pharmacol. 2013 Jan;11(1):112-20.
INTRODUCTION/AIM: We reviewed the literature for studies evaluating the effects of statins on vascular patients undergoing open surgical or endovascular procedures.
MEDLINE was searched using the search terms "statins and vascular surgery", "statins and endovascular procedures", "statins and perioperative effects" and "statins and postoperative complications".
Preoperative statin use is associated with lower perioperative/periprocedural death, myocardial infarction and stroke rates. Statins may also reduce postoperative complications as well as hospitalization rates and costs. Statins reduce the incidence of postoperative/postprocedural renal insufficiency and help the earlier recovery of complete kidney function in vascular patients. A loading dose of statins prior to a procedure may be associated with improved cardiovascular outcomes.
Statins are associated with several beneficial actions in patients undergoing open surgical or endovascular procedures. Nevertheless, statin use in vascular patients still remains underutilized and suboptimal. Ideally, statins should be initiated a minimum of 2 weeks before the procedure. Extended-release formulas may be preferable perioperatively to cover the first 1-2 days after the procedure when oral intake may not be feasible. Statins should be administered to all vascular disease patients, whether they are managed conservatively or are undergoing open surgical or endovascular procedures.
简介/目的:我们回顾了评估他汀类药物对接受开放手术或血管内手术的血管患者的影响的研究文献。
使用“他汀类药物和血管手术”、“他汀类药物和血管内程序”、“他汀类药物和围手术期效果”和“他汀类药物和术后并发症”等搜索词在 MEDLINE 上进行搜索。
术前使用他汀类药物与较低的围手术期/围手术期死亡、心肌梗死和中风发生率相关。他汀类药物还可能降低术后并发症发生率以及住院率和费用。他汀类药物可降低血管患者术后/术后肾功能不全的发生率,并有助于血管患者肾功能的早期恢复。在手术前使用他汀类药物的负荷剂量可能与改善心血管结局有关。
他汀类药物在接受开放手术或血管内手术的患者中具有多种有益作用。然而,他汀类药物在血管患者中的使用仍然不足且不理想。理想情况下,应在手术前至少 2 周开始使用他汀类药物。在术后的头 1-2 天,当口服摄入不可行时,可能需要使用延长释放剂型来覆盖,因为此时可能无法口服摄入。无论血管疾病患者是接受保守治疗还是接受开放手术或血管内手术,都应给予他汀类药物。