Cleveland Clinic Study Shows Post-Operative Statin Treatment Lowers Incidence of Stroke
Cleveland Clinic researchers have discovered that patients undergoing coronary artery bypass grafting (CABG) can reduce their risk of post-operative stroke by taking statin therapy to reduce their levels of LDL (low-density lipoprotein) or “bad” cholesterol.
Post-operative stroke remains a catastrophic and costly complication of CABG. Prior research has demonstrated a significant reduction in the rate of stroke associated with statin use in the non-operative setting. Cleveland Clinic researchers led by Matthew Becker, M.D., evaluated the effect of post-operative statin use and LDL cholesterol concentration (LDL-C) on the incidence of stroke following CABG.
Results of “Post-Operative Statin Use and Lower LDL Cholesterol Concentration Are Associated with Reduced Incidence of Stroke” were presented at the American Heart Association’s 27th Annual Scientific Session currently underway in Orlando, Fla.
“In patients undergoing first-time bypass surgery, we found that post-operative statin therapy was associated with lower LDL-C and significantly reduced the risk of stroke in the year following surgery,” Dr. Becker said. “This data suggests that a discharge regimen including statin therapy may reduce post-operative morbidity and warrants further study.”
The Cleveland Clinic cardiothoracic surgery database was used to identify 5,205 consecutive patients who underwent first time, isolated CABG from 1993 to 2005. Patients with a prior history of atrial fibrillation, known clotting disorders, or requirement for anticoagulation were excluded from the analysis. Discharge medications, including statins, were prospectively collected. Patients were divided into groups based upon serum LDL-C.
The overall incidence of postoperative stroke at one year was 3.3% (181 events). Patients discharged on statin therapy were more likely to have a lower LDL-C and were significantly less likely to suffer a post operative stroke at one year. Multivariate logistic regression identified age (HR 1.05 [1.024, 1.075]; p<0.001), peripheral vascular disease (1.89[1.233, 2.891]; p<0.004), and renal disease (2.79 [1.654, 4.709]; p<0.001) as independent predictors of the combination of stroke, heart attack, or death. Use of both statin (0.366 [0.177, 0.757]; p<0.007) and ACE inhibitor (0.545 [0.36, 0.82]; p<0.003) therapies significantly reduced this risk.
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Approximately 1,800 full-time salaried physicians and researchers at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties. In 2006, there were 3.1 million outpatient visits to Cleveland Clinic. Patients came for treatment from every state and from more than 80 countries. There were more than 53,000 hospital admissions to Cleveland Clinic in 2006. Cleveland Clinic’s Web site address is www.clevelandclinic.org.
