Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Anesthesiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.
J Cardiothorac Vasc Anesth. 2022 Apr;36(4):1014-1020. doi: 10.1053/j.jvca.2021.07.031. Epub 2021 Jul 24.
The existing literature has shown conflicting results regarding the association between preoperative statin exposure and the risk of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI).
A single-center retrospective observational study.
A single, large, tertiary care center.
Adult patients undergoing open cardiac surgery between January 1, 2012 and January 1, 2019.
AKI was defined using the Kidney Disease: Improving Global Outcomes criteria. A multivariate logistic regression analysis and propensity score-matched analysis were used to study the association.
A total of 58,399 patient charts were retrospectively reviewed. The preoperative statin exposure cohort had a lower prevalence of all stages of CSA-AKI (30.7% v 36.3%, p < 0.001) and stage 3 CSA-AKI (0.9% v 2.1%, p < 0.001). After adjusting for confounding factors, preoperative statin exposure was a protective factor against all stages of postoperative CSA-AKI (odds ratio [OR], 0.885, 95% confidence interval [CI], 0.852-0.920, p < 0.001) and stage 3 CSA-AKI in adults (OR, 0.671, 95% CI, 0.567-0.795, p < 0.001). A propensity score-matched analysis showed that the preoperative statin exposure cohort had a lower risk of all stages of postoperative CSA-AKI (30.7% v 35.3%, p < 0.001) and stage 3 CSA-AKI (0.9% v 2.2%, p < 0.001) than the control cohort.
Preoperative statin exposure was associated with all stages of postoperative CSA-AKI and stage 3 CSA-AKI.
现有文献对于术前他汀类药物暴露与心脏手术后相关急性肾损伤（CSA-AKI）风险之间的关系存在相互矛盾的结果。
单中心回顾性观察性研究。
单一大型三级护理中心。
2012 年 1 月 1 日至 2019 年 1 月 1 日期间接受开放心脏手术的成年患者。
使用肾脏病：改善全球结果（KDIGO）标准定义 AKI。采用多变量逻辑回归分析和倾向评分匹配分析来研究相关性。
共回顾了 58399 份患者病历。术前他汀类药物暴露组 CSA-AKI 的所有阶段（30.7%比 36.3%，p<0.001）和 3 期 CSA-AKI（0.9%比 2.1%，p<0.001）的患病率较低。在调整混杂因素后，术前他汀类药物暴露是术后 CSA-AKI 所有阶段（比值比[OR]，0.885，95%置信区间[CI]，0.852-0.920，p<0.001）和成人 3 期 CSA-AKI 的保护因素（OR，0.671，95%CI，0.567-0.795，p<0.001）。倾向评分匹配分析显示，术前他汀类药物暴露组术后 CSA-AKI 的所有阶段（30.7%比 35.3%，p<0.001）和 3 期 CSA-AKI（0.9%比 2.2%，p<0.001）的风险均低于对照组。
术前他汀类药物暴露与术后 CSA-AKI 的所有阶段和 3 期 CSA-AKI 相关。
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