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The effect of preoperative statin treatment on acute kidney injury in elderly patients undergoing valve replacement surgery

  • Pharmacoepidemiology and Prescription
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Abstract

Purposes

The effects of preoperative statin treatment on acute kidney injury (AKI) remain controversial, and current clinical evidence regarding statin use in the elderly undergoing valve replacement surgery (VRS) is insufficient. The present study aimed to investigate the association between preoperative statin treatment and AKI after VRS in the elderly.

Methods

Three thousand seven hundred ninety-one elderly patients (≥ 60 years) undergoing VRS were included in this study and divided into 2 groups, according to the receipt of statin treatment before the operation: statin users (n = 894) and non-users (n = 2897). We determined the associations between statin use, AKI, and other adverse events using a multivariate model and propensity score-matched analysis.

Results

After propensity score-matched analysis, there was no difference between statin users and non-users in regard to postoperative AKI (72.5% vs. 72.4%, p = 0.954), in-hospital death (5.7% vs. 5.1%, p = 0.650) and 1-year mortality (log-rank = 0, p = 0.986). The multivariate analysis showed that statin use was not an independent risk factor for postoperative AKI (OR = 0.97, 95% CI: 0.90–1.17, p = 0.733), in-hospital mortality (OR = 1.12, 95% CI: 0.75–1.68, p = 0.568), or 1-year mortality (HR = 0.95, 95% CI: 0.70–1.28, p = 0.715).

Conclusion

Preoperative statin treatment did not significantly affect the risk of AKI among elderly patients undergoing VRS.

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Data availability

The data generated or analyzed during this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Abbreviations

AKI: :

Acute kidney injury

VRS: :

Valve replacement surgery

CSA-AKI: :

Cardiac surgery-associated acute kidney injury

SCr: :

Serum creatinine

LVEF: :

Left ventricular ejection fraction

AVR: :

Aortic valve replacement

MVR: :

Mitral valve replacement

TVI: :

Tricuspid valve intervention

CABG: :

Coronary artery bypass graft surgery

CAD: :

Coronary artery disease

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Acknowledgements

Not applicable.

Funding

This study was supported by grants from the National Natural Science Foundation of China [grant no. 82002014], the Science and Technology Projects of Guangzhou [grant no. 201903010097], the National Clinical Key Specialty Construction Project of China [grant no. 2012–649 and 2013–544], and Natural Science Foundation of Guangdong Province (grant no. 2021A1515010107). The funders had no role in the study design, data collection and analysis, decision to publish, or the preparation of the manuscript. The work was not funded by any industry sponsors.

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Author notes

  1. Bing-qi Fu and Xue-biao Wei have contributed equally to this work.

Authors and Affiliations

  1. Division of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Bing-qi Fu, Xue-biao Wei, Zedazhong Su, Ying-wen Lin, Zu-hui Ke, Tong Tan, Ji-yan Chen & Dan-qing Yu

  2. Division of Geriatric Intensive Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Xue-biao Wei & Shou-hong Wang

  3. Division of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Tong Tan

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Contributions

DQY, JYC, and SHW were involved in the conception and design of the study. BQF, XBW, ZDZS, YWL, ZHK, and TT contributed to data collection and/or analysis. BQF, XBW, and ZDZS were involved in the construction of the manuscript, which was revised critically and approved by all the authors for publication.

Corresponding author

Correspondence to Dan-qing Yu.

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The study was approved by the Research Ethics Committee of Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences with a waiver of written informed consent (No. GDREC2018525H).

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The authors declare no competing interests.

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Fu, Bq., Wei, Xb., Su, Z. et al. The effect of preoperative statin treatment on acute kidney injury in elderly patients undergoing valve replacement surgery. Eur J Clin Pharmacol 78, 505–512 (2022). https://doi.org/10.1007/s00228-021-03252-4

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