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Rupture of coronary plaque probably accounts for half of perioperative myocardial infarctions. Because statins have plaque-stabilizing effects, they are plausible candidates for preventing perioperative MIs.
In the industry-supported DECREASE-III trial, Dutch researchers randomized 497 statin-naive patients scheduled for elective vascular surgery (carotid, aortic, or lower extremity) to receive daily extended-release fluvastatin (80 mg) or placebo. Fluvastatin was started at least several weeks before surgery and was continued for 1 month postoperatively. Patients were at high risk: 28% had suffered previous MIs, 38% had experienced previous cerebrovascular events, 57% were hypertensive, and 20% had diabetes.
The primary endpoint, myocardial …