Cheng Xiaocheng, Hu Qiongwen, Liu Zengzhang, Tang Xuewen
Department of Cardiology, Banan People's Hospital of Chongqing.
Department of Clinical laboratory, The Third People׳s Hospital of Chongqing.
J Cardiothorac Vasc Anesth. 2015 Feb;29(1):107-14. doi: 10.1053/j.jvca.2014.08.013.
The purpose of this meta-analysis was to assess the role of preoperative statin therapy on adverse cardiovascular events in patients undergoing valve surgery.
Meta-analysis of 10 observational studies.
Hospital.
22,158 patients.
None.
The Medline, Cochrane, and Embase databases were searched for clinical studies published up to June 2014. Studies that evaluated the effects of preoperative statin therapy on valve surgery were included. After a literature search in the major databases, 10 observational studies with 22,518 patients were identified. Pool analysis indicated that preoperative statin therapy was associated with a significantly lower risk of early all-cause mortality (Odds ratio [OR]: 0.69; 95% confidence interval [CI] 0.50-0.95, p = 0.03). The benefits of preoperative statin therapy were more obvious in studies with isolated valve surgery, resulting in a 1.9% absolute risk and a 38% odds reduction of early mortality (2.4 v 4.3%; OR: 0.62; 95% CI 0.49-0.77, p<0.0001). A significant reduction by statin therapy also was observed for atrial fibrillation (OR 0.88, 95% CI: 0.80-0.98, p = 0.02). However, statin therapy was not associated with a lower risk of postoperative stroke (OR: 0.74; 95% CI 0.46-1.19, p = 0.21), myocardial infarction (OR: 1.02; 95% CI 0.78-1.34, p = 0.87), and renal failure (OR: 0.91; 95% CI 0.57-1.44, p = 0.68).
Preoperative statin therapy was associated with a significantly lower risk of early mortality in patients undergoing isolated valve surgery. A prospective, randomized, controlled trial is warranted.
本荟萃分析旨在评估术前他汀类药物治疗对接受瓣膜手术患者不良心血管事件的作用。
对10项观察性研究进行荟萃分析。
医院。
22158例患者。
无。
检索了Medline、Cochrane和Embase数据库中截至2014年6月发表的临床研究。纳入评估术前他汀类药物治疗对瓣膜手术影响的研究。在主要数据库中进行文献检索后，确定了10项观察性研究，共22518例患者。汇总分析表明，术前他汀类药物治疗与早期全因死亡率显著降低相关（比值比[OR]：0.69；95%置信区间[CI] 0.50 - 0.95，p = 0.03）。术前他汀类药物治疗的益处在单纯瓣膜手术的研究中更为明显，早期死亡率的绝对风险降低1.9%，比值降低38%（2.4%对4.3%；OR：0.62；95% CI 0.49 - 0.77，p<0.0001）。他汀类药物治疗还可使房颤显著减少（OR 0.88，95% CI：0.80 - 0.98，p = 0.02）。然而，他汀类药物治疗与术后中风风险降低无关（OR：0.74；95% CI 0.46 - 1.19，p = 0.21），与心肌梗死风险降低无关（OR：1.02；95% CI 0.78 - 1.34，p = 0.87），与肾衰竭风险降低无关（OR：0.91；95% CI 0.57 - 1.44，p = 0.68）。
术前他汀类药物治疗与单纯瓣膜手术患者早期死亡率显著降低相关。有必要进行一项前瞻性、随机、对照试验。
