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Abstract
Myocardial injury after noncardiac surgery (MINS) is recently accepted as a strong predictor of mortality, regardless of symptoms. However, anticoagulation is the only established treatment. This study aimed to evaluate the association between statin treatment and mortality after MINS. From January 2010 to June 2019, a total of 5,267 adult patients who were discharged after the occurrence of MINS were enrolled. The patients were divided into two groups according to statin prescription at discharge. The outcomes were 1-year and overall mortalities. Of the total 5,109 patients, 1,331 (26.1%) patients were in the statin group and 3,778 (73.9%) patients were in the no statin group. The 1-year and overall mortalities were significantly lower in the statin group compared with the no statin group (6.1% vs. 13.3%; hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.41–0.74; p < 0.001 for 1-year mortality and 15.0% vs. 25.0%; HR, 0.62; 95% CI, 0.51–0.76; p < 0.001 for overall mortality). Analyses after inverse probability treatment weighting showed similar results (HR, 0.61; 95% CI, 0.50–0.74; p < 0.001 for 1-year mortality and HR, 0.70; 95% CI, 0.54–0.90; p = 0.006 for overall mortality), and the mortalities did not differ according to the dose of statin. Our results suggest that statin treatment may be associated with improved survival after MINS. A trial is needed to confirm this finding and establish causality.
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1 Sungkyunkwan University School of Medicine, Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Seoul, South Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
2 Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, South Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
3 Sungkyunkwan University School of Medicine, Centers for Health Promotion, Samsung Medical Center, Seoul, South Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
4 Samsung Medical Center, Statistics and Data Center, Research Institute for Future Medicine, Seoul, South Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613); Sungkyunkwan University, Department of Digital Health, SAIHST, Seoul, South Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
5 Samsung Medical Center, Statistics and Data Center, Research Institute for Future Medicine, Seoul, South Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)