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Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation.
J Heart Lung Transplant 2017; 36(9):948-956JH

Abstract

BACKGROUND

Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation.

METHODS

We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System. The primary outcome was PGD (grades 1-3). Secondary outcomes included grade 3 PGD, length of intensive care unit and hospital stay, and mortality.

RESULTS

Of 266 patients who met final inclusion criteria, 138 (52%) were diagnosed with PGD. In-hospital mortality among patients with PGD was 6.5%. There were no deaths in patients without PGD (p < 0.001). PGD was diagnosed in 24 patients taking statins (34.8%) and in 114 patients (57.9%) who did not take statins (p = 0.001). After propensity score adjustments, perioperative statin use was independently associated with a reduced risk for PGD (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20-0.84, p = 0.015) and reduced risk to develop grade 3 PGD (OR 0.42, 95% CI 0.18-0.94, p = 0.036). Other risk factors associated with PGD included intraoperative use of cardiopulmonary bypass (OR 3.74, 95% CI 1.75-8.02, p = 0.001) and positive donor smoking status (OR 2.27, 95% CI 1.18-4.35, p = 0.014).

CONCLUSIONS

The results demonstrate that perioperative use of statins is independently associated with reduced risk for PGD after lung transplantation.

Authors+Show Affiliations

Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia. Electronic address: jr5ef@virginia.edu.Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia.Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.Division of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.Division of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28552627

Citation

Raphael, Jacob, et al. "Perioperative Statin Use Is Associated With Decreased Incidence of Primary Graft Dysfunction After Lung Transplantation." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 36, no. 9, 2017, pp. 948-956.
Raphael J, Collins SR, Wang XQ, et al. Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation. J Heart Lung Transplant. 2017;36(9):948-956.
Raphael, J., Collins, S. R., Wang, X. Q., Scalzo, D. C., Singla, P., Lau, C. L., ... Blank, R. S. (2017). Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 36(9), pp. 948-956. doi:10.1016/j.healun.2017.05.007.
Raphael J, et al. Perioperative Statin Use Is Associated With Decreased Incidence of Primary Graft Dysfunction After Lung Transplantation. J Heart Lung Transplant. 2017;36(9):948-956. PubMed PMID: 28552627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation. AU - Raphael,Jacob, AU - Collins,Stephen R, AU - Wang,Xin-Qun, AU - Scalzo,David C, AU - Singla,Priyanka, AU - Lau,Christine L, AU - Kozower,Benjamin D, AU - Durieux,Marcel E, AU - Blank,Randal S, Y1 - 2017/05/06/ PY - 2016/11/24/received PY - 2017/03/21/revised PY - 2017/05/03/accepted PY - 2017/5/30/pubmed PY - 2018/6/12/medline PY - 2017/5/30/entrez KW - lung transplantation KW - mortality KW - outcomes KW - primary graft dysfunction KW - statins SP - 948 EP - 956 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 36 IS - 9 N2 - BACKGROUND: Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. METHODS: We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System. The primary outcome was PGD (grades 1-3). Secondary outcomes included grade 3 PGD, length of intensive care unit and hospital stay, and mortality. RESULTS: Of 266 patients who met final inclusion criteria, 138 (52%) were diagnosed with PGD. In-hospital mortality among patients with PGD was 6.5%. There were no deaths in patients without PGD (p < 0.001). PGD was diagnosed in 24 patients taking statins (34.8%) and in 114 patients (57.9%) who did not take statins (p = 0.001). After propensity score adjustments, perioperative statin use was independently associated with a reduced risk for PGD (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20-0.84, p = 0.015) and reduced risk to develop grade 3 PGD (OR 0.42, 95% CI 0.18-0.94, p = 0.036). Other risk factors associated with PGD included intraoperative use of cardiopulmonary bypass (OR 3.74, 95% CI 1.75-8.02, p = 0.001) and positive donor smoking status (OR 2.27, 95% CI 1.18-4.35, p = 0.014). CONCLUSIONS: The results demonstrate that perioperative use of statins is independently associated with reduced risk for PGD after lung transplantation. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/28552627/Perioperative_statin_use_is_associated_with_decreased_incidence_of_primary_graft_dysfunction_after_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(17)31783-7 DB - PRIME DP - Unbound Medicine ER -