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Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies

dc.contributor.authorFallouh, Nabilen_US
dc.contributor.authorChopra, Vineeten_US
dc.date.accessioned2012-10-02T17:20:10Z
dc.date.available2013-10-18T17:47:30Zen_US
dc.date.issued2012-09en_US
dc.identifier.citationFallouh, Nabil; Chopra, Vineet (2012). "Statin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategies." Journal of Hospital Medicine 7(7): 573-579. <http://hdl.handle.net/2027.42/93700>en_US
dc.identifier.issn1553-5592en_US
dc.identifier.issn1553-5606en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/93700
dc.description.abstractBACKGROUND: A growing body of research suggests that statins improve perioperative cardiac outcomes by attenuating inflammation. Conversely, some studies suggest that withdrawal of statins after surgery results in an upsurge of inflammation and adverse cardiac outcomes. METHODS: We performed a literature search using multiple medical databases to examine the basic, clinical, and experimental evidence supporting the existence of a statin withdrawal state. Studies examining outcomes associated with statin withdrawal were narratively synthesized. RESULTS: Published evidence suggests that statin withdrawal is associated with worse cardiac outcomes in a variety of scenarios, including acute coronary syndrome, ischemic stroke, and surgery. Although certain reasons for postoperative statin cessation are difficult to avoid (eg, ileus after surgery), we posit that many perioperative clinicians may be unaware of the importance of statin resumption in a timely fashion. This lack of awareness translates into preventable harm and an opportunity for outcome improvement. We introduce innovative practices through which perioperative practitioners may prevent statin discontinuation. CONCLUSIONS: Ensuring the resumption of statins after surgery should become routine practice for perioperative providers. We highlight knowledge gaps and identify a research agenda aimed at better understanding this practice. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicineen_US
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.titleStatin withdrawal after major noncardiac surgery: Risks, consequences, and preventative strategiesen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelMedicine (General)en_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDepartment of General Internal Medicine, University of Michigan Health System, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of General Internal Medicine, University of Michigan Health System, 1500 E Medical Center Dr, SPC 5376, Ann Arbor, MI 48109en_US
dc.identifier.pmid22744758en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/93700/1/1945_ftp.pdf
dc.identifier.doi10.1002/jhm.1945en_US
dc.identifier.sourceJournal of Hospital Medicineen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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