Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, South Korea.
Sci Rep. 2020 Jul 15;10(1):11616. doi: 10.1038/s41598-020-68511-3.
Myocardial injury after noncardiac surgery (MINS) is recently accepted as a strong predictor of mortality, regardless of symptoms. However, anticoagulation is the only established treatment. This study aimed to evaluate the association between statin treatment and mortality after MINS. From January 2010 to June 2019, a total of 5,267 adult patients who were discharged after the occurrence of MINS were enrolled. The patients were divided into two groups according to statin prescription at discharge. The outcomes were 1-year and overall mortalities. Of the total 5,109 patients, 1,331 (26.1%) patients were in the statin group and 3,778 (73.9%) patients were in the no statin group. The 1-year and overall mortalities were significantly lower in the statin group compared with the no statin group (6.1% vs. 13.3%; hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.41-0.74; p < 0.001 for 1-year mortality and 15.0% vs. 25.0%; HR, 0.62; 95% CI, 0.51-0.76; p < 0.001 for overall mortality). Analyses after inverse probability treatment weighting showed similar results (HR, 0.61; 95% CI, 0.50-0.74; p < 0.001 for 1-year mortality and HR, 0.70; 95% CI, 0.54-0.90; p = 0.006 for overall mortality), and the mortalities did not differ according to the dose of statin. Our results suggest that statin treatment may be associated with improved survival after MINS. A trial is needed to confirm this finding and establish causality.
心肌损伤非心脏手术后（MINS）最近被认为是死亡率的一个强有力的预测因素，无论是否有症状。然而，抗凝治疗是唯一确立的治疗方法。本研究旨在评估他汀类药物治疗与 MINS 后死亡率之间的关系。
从 2010 年 1 月至 2019 年 6 月，共纳入 5267 例发生 MINS 后出院的成年患者。根据出院时他汀类药物的处方将患者分为两组。结局为 1 年和总体死亡率。在 5109 例患者中，1331 例（26.1%）患者为他汀类药物组，3778 例（73.9%）患者为非他汀类药物组。他汀类药物组的 1 年和总体死亡率明显低于非他汀类药物组（6.1%比 13.3%；危险比[HR]，0.55；95%置信区间[CI]，0.41-0.74；p<0.001）和 1 年死亡率（15.0%比 25.0%；HR，0.62；95%CI，0.51-0.76；p<0.001）。逆概率治疗权重分析结果相似（HR，0.61；95%CI，0.50-0.74；p<0.001）和 1 年死亡率（HR，0.70；95%CI，0.54-0.90；p=0.006）和总体死亡率），并且死亡率与他汀类药物的剂量无关。
我们的研究结果表明，他汀类药物治疗可能与 MINS 后生存率的提高有关。需要进行一项试验来证实这一发现并确定因果关系。
