Should Statin Use Be Discontinued For Surgery?

Patients who cease statin use prior to surgery are following outdated recommendations and are at a heightened risk of death if they do not resume taking the medication 2 days after surgery, according to a recent study.

A clinical advisory issued in 2002 recommended the discontinuation of perioperative statin use, but the guidance was disputed in 2007 when the American College of Cardiology and American Heart Association began recommending uninterrupted perioperative statin use.
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“We now know that patients should not stop taking their statins around the time of surgery, but some providers may still be following outdated recommendations to suspend them temporarily,” researchers wrote.

For the current study, researchers evaluated the health records of 307,151 statin users who had been admitted for non-cardiac surgery to the Veterans Affairs Healthcare system between 2000 and 2014.

Overall, 31.9% of patients (98,014) failed to resume statin use within 2 days post-surgery.

Next, researchers examined mortality rates in participants 30 days after surgery. The mortality rate for participants who did not resume statin us within 2 days after surgery was 2.6%, 40% higher than in those who resumed statin use immediately after surgery or who never stopped taking the medication.

“Unfortunately, the drug information for statins still comes with a warning to temporarily discontinue them during surgery,” said Susan M. Lee, MD, lead author of the study and clinical instructor in the Department of Anesthesia and Perioperative Care at the University of California, San Francisco.

“Patients and their doctors need to understand the importance of continuing statins throughout surgery, a simple act that may reduce the risk of complications and death after the procedure,” she concluded.

The complete study was presented at the Anesthesiology 2015 annual meeting.

-Michelle Canales Butcher

Reference:
American Society of Anesthesiologists. Surgical patients should stay on cholesterol medications to reduce risk of death, study shows. October 27, 2015. www.asahq.org/about-asa/newsroom/news-releases/2015/10/surgical-patients-should-stay-on-cholesterol-medications. Accessed October 28, 2015.