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Statins Before Vascular Surgery Cut Deaths, Complications
Date:9/2/2009

otid artery, the main artery to the brain, in people who had or had not been taking a statin before the operation. "We showed in our study a significantly lower incidence of 30-day stroke and 30-day deaths [with statin treatment]," Perler said.

That study did not distinguish between the various statins being used, but "there is no reason to believe that this isn't a class effect," said Dr. Louis E. Teichholz, medical director of the division of cardiology at Hackensack University Medical Center, in New Jersey. "No matter which statin you give, there is no major difference over another statin."

The major reason for the benefit in surgery probably is not the cholesterol-lowering effects of statins, Perler and Teichholz noted, because the benefit was seen in people who did not have high cholesterol.

The drugs also reduce inflammation, and the Dutch study found marked reductions in markers of inflammation in those given a statin, Teichholz said.

"Statins also have major anti-thrombotic [clot-preventing] effects and are antioxidants," Perler said.

There are no current guidelines recommending use of statins before vascular surgery, but the concept seems to be taking hold in clinical practice, Teichholz noted. "It appears to be what we should be doing, barring contraindications," he said. "There are no official guidelines but, based on this and other studies, it would be prudent to consider statins in patients with vascular disease."

Statins can cause acute muscle pain in a minority of people, and they can be dangerous in people with poor liver function, but are otherwise safe, Teichholz said.

One practical reason why physicians might not prescribe a statin before vascular surgery is that so many people already are taking them, Perler said. "In my practice, it is very unusual to see patients who are not on statins," he added.

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