Your browser doesn't support javascript.
loading
Statin loading before coronary artery bypass grafting: a randomized trial.
Liakopoulos, Oliver J; Kuhn, Elmar W; Hellmich, Martin; Schlömicher, Markus; Strauch, Justus; Reents, Wilko; Diegeler, Anno; Thielmann, Matthias; Wendt, Daniel; Börgermann, Jochen; Gummert, Jan F; Stoppe, Christian; Goetzenich, Andreas; Martens, Sven; Reichenspurner, Hermann; Wippermann, Jens; Reuter, Hannes; Choi, Yeong-Hoon; Wahlers, Thorsten.
Afiliación
  • Liakopoulos OJ; Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
  • Kuhn EW; Department of Cardiac Surgery, Kerckhoff-Clinic, Campus Kerckhoff, Justus-Liebig-University of Giessen, Benekestr. 2-8, 61231 Bad Nauheim, Germany.
  • Hellmich M; Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
  • Schlömicher M; Institute of Medical Statistics and Computational Biology, University Hospital Cologne, Cologne, Germany.
  • Strauch J; Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bochum, Germany.
  • Reents W; Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bochum, Germany.
  • Diegeler A; Department of Cardiac Surgery, Bad Neustadt a. d. Saale, Germany.
  • Thielmann M; Department of Cardiac Surgery, Bad Neustadt a. d. Saale, Germany.
  • Wendt D; Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany.
  • Börgermann J; Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany.
  • Gummert JF; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
  • Stoppe C; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
  • Goetzenich A; Department of Thoracic and Cardiovascular Surgery, University Hospital Aachen, Aachen, Germany.
  • Martens S; Department of Thoracic and Cardiovascular Surgery, University Hospital Aachen, Aachen, Germany.
  • Reichenspurner H; Department of Cardiac and Thoracic Surgery, University Hospital Münster, Münster, Germany.
  • Wippermann J; Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
  • Reuter H; Department of Cardiothoracic Surgery, Otto-von Guericke University, Magdeburg, Germany.
  • Choi YH; Department of Cardiology, University Hospital Cologne, Cologne, Germany.
  • Wahlers T; Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
Eur Heart J ; 44(25): 2322-2331, 2023 Jul 01.
Article en En | MEDLINE | ID: mdl-37086268
AIMS: Evidence suggests that a high-dose statin loading before a percutaneous coronary revascularization improves outcomes in patients receiving long-term statins. This study aimed to analyse the effects of such an additional statin therapy before surgical revascularization. METHODS AND RESULTS: This investigator-initiated, randomized, double-blind, and placebo-controlled trial was conducted from November 2012 to April 2019 at 14 centres in Germany. Adult patients (n = 2635) with a long-term statin treatment (≥30 days) who were scheduled for isolated coronary artery bypass grafting (CABG) were randomly assigned to receive a statin-loading therapy or placebo at 12 and 2 h prior to surgery using a web-based system. The primary outcome of major adverse cardiac and cerebrovascular events (MACCE) was a composite consisting of all-cause mortality, myocardial infarction (MI), and a cerebrovascular event occuring within 30 days after surgery. Key secondary endpoints included a composite of cardiac death and MI, myocardial injury, and death within 12 months. Non-statistically relevant differences were found in the modified intention-to-treat analysis (2406 patients; 1203 per group) between the statin (13.9%) and placebo groups (14.9%) for the primary outcome [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.74-1.18; P = 0.562] or any of its individual components. Secondary endpoints including cardiac death and MI (12.1% vs. 13.5%; OR 0.88, 95% CI 0.69-1.12; P = 0.300), the area under the troponin T-release curve (median 0.398 vs. 0.394 ng/ml, P = 0.333), and death at 12 months (3.1% vs. 2.9%; P = 0.825) were comparable between treatment arms. CONCLUSION: Additional statin loading before CABG failed to reduce the rate of MACCE occuring within 30 days of surgery.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Intervención Coronaria Percutánea / Infarto del Miocardio Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Humans Idioma: En Revista: Eur Heart J Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Intervención Coronaria Percutánea / Infarto del Miocardio Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Humans Idioma: En Revista: Eur Heart J Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido