Giving statins before any operation could help cut risk of death

GIVING patients statins before any kind of operation could dramatically cut risk of death or complications immediately after surgery, researchers say.

The cholesterol-busting drugs are routinely used by patients with heart conditions and also given before heart surgery to prevent complications.

But administering statins to people having surgery that is unrelated to their hearts could halve their chances of dying in the following month, a study suggests.

Research on more than 6,000 people found giving statins before a range of operations, including hip replacements, cut risk of heart complications by 17 per cent.

Statins were linked to a 43 per cent lower chance of dying from any cause and reduced risk of dying from a heartrelated problem within 30 days of surgery by 52 per cent. Levels of heart injury were reduced by 14 per cent.

Dr Philip Devereaux, from McMaster University in Canada, said: ‘Among the 200million adults worldwide who undergo non-cardiac surgery annually, more than 10million will suffer a cardiovascular complication in the first 30 days after surgery.

‘Despite the magnitude of the problem, no intervention has been shown to be both safe and effective in the prevention of cardiovascular

complications such as heart attack,

death due to cardiac causes and stroke. Our finding of reduced major cardiac complications and all- cause mortality after non- cardiac surgery in patients taking statins suggests that there may be a new indication for this drug.’ Dr Devereaux said more work was needed – possibly a trial testing statins before hip replacements – and the findings did not add up to a formal recommendation to prescribe statins before surgery. Researcher Dr Otavio Berwanger, of the Research Institute HCor in Sao Paulo, Brazil, said the evidence was not yet strong enough to recommend statins routinely as a preventive measure. He added: ‘But it is promising and provides the basis to inform the design of a future large international randomised trial that is required to answer this question reliably and definitively.’

The study, involving eight countries, was presented at the European Society of Cardiology Congress in London. Researchers looked at 15,478 patients aged over 45 who had non- cardiac surgery from 2007 to 2011. Two groups of ‘ matched’ patients were then selected for analysis of outcomes, with 2,845 patients on statins and 4,492 who were not.

Professor Peter Weissberg, medical director at the British Heart Foundation, said: ‘One of the main complications of major surgery is the occurrence of heart attacks and strokes during or shortly after the operation.

‘This large observational study showed that patients taking statins had fewer heart attacks and strokes following surgery than those not on statins, suggesting that statins may protect surgical patients from cardiovascular events.

‘What we need now is a welldesigned prospective study that compares statins with a placebo to determine whether or not statins really do protect patients undergoing surgery. Such a study, if positive, could lead to a cheap and effective way of reducing serious complication after surgery.’

Statins are the UK’s most widely prescribed drug, taken by between 8million and 10million Britons.