Perioperative Rosuvastatin Not Beneficial in Cardiac-Surgery Patients

By Joel M. Gore, MD

Dr. Gore in an associate editor for NEJM Journal Watch Cardiology, from which this story was adapted. See full coverage at the link below.

Perioperative rosuvastatin doesn't reduce postoperative complications in patients undergoing elective cardiac surgery, a New England Journal of Medicine study suggests.

Over 1900 patients in China in sinus rhythm who were scheduled for elective cardiac surgery were randomized to perioperative rosuvastatin (20 mg/day) or placebo. Treatment began up to 8 days before surgery and lasted until 5 days afterwards.

Rates of the two coprimary outcomes — postoperative atrial fibrillation and myocardial injury within 5 days of surgery — did not differ significantly between the groups. Acute kidney injury was more common with rosuvastatin than with placebo (25% vs. 19%).

Comment: Although previous small studies yielded positive results, perioperative rosuvastatin therapy in this larger, placebo-controlled trial did not lower incidence of postoperative atrial fibrillation or perioperative myocardial damage. The search continues for strategies to limit postoperative atrial fibrillation and myocardial damage. Moderate-to-intense statin therapy is still recommended for patients with coronary atherosclerosis.