Yu Tian1, Xiuyuan Li2, Yuefu Wang3, Wei Zhao4, Chunrong Wang5, Yuchen Gao5, Sudena Wang5, Jia Liu5. 1. 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. 2. Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China. 3. Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Surgery Intensive Care Unit & Center of Anesthesia, Beijing Shijitan Hospital, Capital Medical University, Beijing, China. Electronic address: wangyuefu3806@bjsjth.cn. 4. Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. 5. Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Abstract
OBJECTIVES: 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). DESIGN: A single-center retrospective observational study. SETTING: A single, large, tertiary care center. PARTICIPANTS: Adult patients undergoing open cardiac surgery between January 1, 2012 and January 1, 2019. INTERVENTIONS: 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. MEASUREMENTS AND MAIN RESULTS: 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. CONCLUSIONS: Preoperative statin exposure was associated with all stages of postoperative CSA-AKI and stage 3 CSA-AKI.
OBJECTIVES: 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). DESIGN: A single-center retrospective observational study. SETTING: A single, large, tertiary care center. PARTICIPANTS: Adult patients undergoing open cardiac surgery between January 1, 2012 and January 1, 2019. INTERVENTIONS: 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. MEASUREMENTS AND MAIN RESULTS: 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. CONCLUSIONS: Preoperative statin exposure was associated with all stages of postoperative CSA-AKI and stage 3 CSA-AKI.
Authors: Vladimir Shvartz; Eleonora Khugaeva; Yuri Kryukov; Maria Sokolskaya; Artak Ispiryan; Elena Shvartz; Andrey Petrosyan; Elizaveta Dorokhina; Leo Bockeria; Olga Bockeria Journal: Pathophysiology Date: 2022-07-11