High Dose Statins Did Not Reduce Risk of Kidney Injury After Cardiac Surgery

MedicalResearch.com Interview with:

Frederic T. Billings

Dr. Frederic T.Billings

Frederic T. Billings IV, MD, MSc
Assistant Professor of Anesthesiology and Medicine
Additional Specialty: Cardiothoracic Anesthesiology
Vanderbilt University

Medical Research: What is the background for this study? What are the main findings?

Dr. Billings: Acute kidney injury (AKI) affects up to 30% of patients following cardiac surgery and is associated with long-term kidney function decline as well as a 5-fold increase in death during hospitalization following surgery. Statins affect several mechanisms of AKI following cardiac surgery including improvement of endothelial function and attenuation of oxidative stress, so we performed a clinical trial to test the hypothesis that high-dose atorvastatin (brand name Lipitor) use prior to and following surgery reduces AKI following cardiac surgery.

In 615 patients who completed the study high-dose atorvastatin treatment, compared to placebo administration, did not reduce the risk of AKI overall, among patients naïve to statins, or patients already using a statin. In fact, among patients naïve to statins with baseline chronic kidney disease we found some evidence that atorvastatin may increase risk for kidney injury, although the number of patients was small in this subgroup.

Medical Research: What should clinicians and patients take away from your report?

Dr. Billings: These results do not support the initiation of statin therapy to prevent AKI following cardiac surgery. 

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Billings: Physician-scientists should examine alternative treatments to improve endothelial function and reduce oxidative stress in order to reduce AKI following cardiac surgery.

Medical Research: Is there anything else you would like to add?

Dr. Billings: This study has no implications on the use of statins to treat cardiovascular disease, where their benefit is well established.

Citation:

Billings FT, IV, Hendricks PA, Schildcrout JS, et al. High-Dose Perioperative Atorvastatin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial. JAMA.Published online February 23, 2016. doi:10.1001/jama.2016.0548.

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Frederic T. Billings IV, MD, MSc (2016). High Dose Statins Did Not Reduce Risk of Kidney Injury After Cardiac Surgery 

Last Updated on February 24, 2016 by Marie Benz MD FAAD