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Review paper

Efficacy of chronic statin therapy on major cardiac events after coronary artery bypass grafting: low-dose versus high-dose

By
Ayşegül Kunt ,
Ayşegül Kunt

Department of Cardiovascular Surgery, School of Medicine, 100.Yil University, Van, Turkey

Sedat Özcan ,
Sedat Özcan
Contact Sedat Özcan

Department of Cardiovascular Surgery, School of Medicine, 18 Mart University, Çanakkale, Turkey

Aslihan Küçüker ,
Aslihan Küçüker

Department of Cardiac Surgery, Ataturk Education and Research Hospital, Ankara, Turkey

Dolunay Odabaşi ,
Dolunay Odabaşi

Department of Cardiovascular Surgery, School of Medicine, 100.Yil University, Van, Turkey

Alper Sami Kunt
Alper Sami Kunt

School of Medicine, 100.Yil University, Van, Turkey

Abstract

Aim
To investigate whether chronic statin treatment after coronary artery bypass grafting (CABG) protects patients from major
cardiac events and provides percutaneous coronary intervention (PCI) free survival.
Methods
A total of 232 patients with previous CABG and chronic statin therapy were selected retrospectively and were divided into
two groups according to a dosage of atorvastatin per day, e. g., 20 mg or 40 mg. Groups were compared for the major cardiac events and freedom from PCI by Kaplan Meier analysis as the primary end point. Patency of grafts including left internal thoracic artery (LITA) and saphenous vein (SVG) and progression of non-grafted native vessel disease were also evaluated as secondary end points.
Results
Cardiac mortality, periprocedural myocardial infarction (MI), target vessel revascularization and percutaneous coronary intervention free survival were as follows: 2.9% versus 2.1% (p=1.000); 16.1% versus 21.1% (p=0.331); 56.93% versus
52.63% (p>0.005); 58.4% versus 63.2% (log-rank test; p= 0.347) in atorvastatin 20 mg and atorvastatin 40 mg groups, respectively. However, these results were not statistically significant between two groups (p>0.005). Patency of openness of grafts including LITA and SVG and progression of non-grafted native vessel disease were similar between groups (p=0.112, p=0.779, p=0.379 and p=0.663, respectively).
Conclusion
Low-dose long-term statin treatment had similar outcomes on major cardiac events and identical rate of freedom
from percutaneous coronary intervention after coronary artery bypass grafting compared with high-dose long-term statin treatment. It is better to start from low dose statin treatment after surgical interventions.

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