Peri-Op Statin Therapy Does Not Prevent AKI After Cardiac Surgery
The trial was stopped for futility after 615 patients completed the study.
HealthDay News — Among adults undergoing cardiac surgery, perioperative atorvastatin does not reduce the risk of acute kidney injury (AKI), according to a study published online February 23 in the Journal of the American Medical Association. The research was published to coincide with the Society of Critical Care Medicine's 45th Critical Care Congress in Orlando, Fla.
Frederic T. Billings IV, MD, from the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues randomized 199 patients, naive to statin treatment, to receive perioperative atorvastatin (102 patients) or matching placebo (97 patients). In addition, 416 patients already taking a statin prior to study enrollment were randomized to perioperative atorvastatin (206 patients) or matching placebo (210).
The trial was stopped for futility after 615 patients completed the study. The researchers found that AKI occurred in 20.8% of the atorvastatin group and 19.5% in the placebo group among all 615 participants (relative risk [RR], 1.06; 95 percent confidence interval [CI], 0.78 to 1.46). AKI occurred in 21.6% and 13.4% of patients in the atorvastatin and placebo groups, respectively, among patients naive to statin treatment (RR, 1.61; 95 percent CI, 0.86 to 3.01). Among patients already taking a statin, AKI occurred in 20.4% and 22.4% of the atorvastatin and placebo groups, respectively (RR, 0.91; 95 percent CI, 0.63 to 1.32).
"These results do not support the initiation of statin therapy to prevent AKI following cardiac surgery," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
- Billings FT IV, Hendricks PA, Schildcrout JS, et al. High-Dose Perioperative Atorvastatin and Acute Kidney Injury Following Cardiac Surgery. JAMA. 2016; doi: 10.1001/jama.2016.0548
- Bellomo R. Perioperative Statins in Cardiac Surgery and Acute Kidney Injury. JAMA. 2016; doi: 10.1001/jama.2016.0245