Statin before bypass surgery may boost survival

NEW YORK, Apr 27 (Reuters) A study hints that taking a statin or other cholesterol-lowering drug before heart bypass surgery may boost survival. However, investigators caution that the improvement may be more directly associated with factors other than cholesterol-lowering medication.

Dr. Brian D. Powell of the Mayo Clinic in Rochester, Minnesota, and colleagues analyzed the outcome of 4,739 patients undergoing bypass surgery for the first-time between 1995 and 2001.

There were 2,334 patients who were on lipid-lowering therapy during the 30-day period prior to surgery and 2,405 patients who were not.

Powell and colleagues found that cholesterol-lowering therapy decreases a 36 per cent in the risk of dying in the hospital after heart bypass surgery.

But the team says that ''patient risk factors and other cardioprotective medication use associated with the use of preoperative lipid-lowering therapy appear to explain the association with improved survival.'' For example, patients on statins and other cholesterol-lowering agents tended to be younger, with an average age of 66 years compared with 68 years for the other group. Thirty-one per cent of patients on cholesterol-lowering therapy had diabetes compared with 28 per cent of those who were not. Other heart drugs called beta-blockers were taken by 70 per cent of those taking cholesterol-lowering therapy compared with 77 per cent of those who were not.

Despite the relatively large sample size, ''we were unable to show that lipid-lowering therapy is independently associated with lower postoperative mortality...however, patients on statins had a lower risk profile,'' Powell's team writes in the American Journal of Cardiology.

''After adjustment for other risk factors, statin use was not associated with a significant decrease in mortality,'' they report.

Powell tells Reuters Health that ''it is still important'' for patients having heart bypass surgery to take lipid-lowering therapy ''because there are long-term survival benefits in patients with coronary artery disease.'' REUTERS PJ RK0914