Perioperative Use Of Statins: The Evidence For Improved Postoperative Cardiac Outcomes With Fluvastatin Extended Release

SHORT REPORT, 15 November 2009, VOL I ISSUE I, ISSN 1756-0993
doi: 10.5083/ejcm.20424884.11 , Cite or Link Using DOI
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Don Poldermans

Perioperative myocardial infarctions (PMIs) are the predominant cause of morbidity and mortality in patients undergoing surgery. Unfortunately the exact underlying mechanism of a PMI is still not clear. Coronary plaque rupture, leading to thrombus formation and subsequent vessel occlusion, is considered to be an important cause of acute perioperative coronary syndromes. This is similar to MIs occurring in the non-operative setting. Surgery itself is a significant stress factor leading to an increased risk of plaque rupture. Statins are widely prescribed in patients with, or at risk of coronary heart disease because of their effectiveness in lowering serum cholesterol concentrations through 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibition. Statins should be started in high risk surgery patients, optimally between 30 days and at least one week before surgery and should be continued perioperatively.

Correspondence:
Don Poldermans, Department of Surgery, Erasmus Medical Centre, Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. d.poldermans@erasmusmc.nl

Keywords:

myocardial infarctions, fluvastatin, pharmacological risk reduction, improved postoperative cardiac outcomes