Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery

a randomized, placebo-controlled trial

Jin Ha Park, Jae Kwang Shim, Jong Wook Song, Sarah Soh, Younglan Kwak

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have the potential to reduce acute kidney injury (AKI) after cardiac surgery through their pleiotropic properties. Here we studied the preventive effect of atorvastatin on AKI after valvular heart surgery. Methods: Two-hundred statin-naïve patients were randomly allocated to receive either statin or placebo. Atorvastatin was administered orally to the statin group according to a dosage schedule (80 mg single dose on the evening prior to surgery; 40 mg on the morning of surgery; three further doses of 40 mg on the evenings of postoperative days 0, 1, and 2). AKI incidence was assessed during the first 48 postoperative hours on the basis of Acute Kidney Injury Network criteria. Results: The incidence of AKI was similar in the statin and control groups (21 vs. 26 %, respectively, p = 0.404). Biomarkers of renal injury including plasma neutrophil gelatinase-associated lipocalin and interleukin-18 were also similar between the groups. The statin group required significantly less norepinephrine and vasopressin during surgery, and fewer patients in the statin group required vasopressin. There were no significant differences in postoperative outcomes. Conclusions: Acute perioperative statin treatment was not associated with a lower incidence of AKI or improved clinical outcome in patients undergoing valvular heart surgery. (ClinicalTrials.gov NCT01909739).

Original languageEnglish
Pages (from-to)1398-1407
Number of pages10
JournalIntensive Care Medicine
Volume42
Issue number9
DOIs
Publication statusPublished - 2016 Sep 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Kidney Injury
Thoracic Surgery
Randomized Controlled Trials
Placebos
Incidence
Vasopressins
Interleukin-18
Atorvastatin Calcium
Norepinephrine
Appointments and Schedules
Oxidoreductases
Biomarkers
Kidney
Control Groups
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

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title = "Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery: a randomized, placebo-controlled trial",
abstract = "Purpose: Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have the potential to reduce acute kidney injury (AKI) after cardiac surgery through their pleiotropic properties. Here we studied the preventive effect of atorvastatin on AKI after valvular heart surgery. Methods: Two-hundred statin-na{\"i}ve patients were randomly allocated to receive either statin or placebo. Atorvastatin was administered orally to the statin group according to a dosage schedule (80 mg single dose on the evening prior to surgery; 40 mg on the morning of surgery; three further doses of 40 mg on the evenings of postoperative days 0, 1, and 2). AKI incidence was assessed during the first 48 postoperative hours on the basis of Acute Kidney Injury Network criteria. Results: The incidence of AKI was similar in the statin and control groups (21 vs. 26 {\%}, respectively, p = 0.404). Biomarkers of renal injury including plasma neutrophil gelatinase-associated lipocalin and interleukin-18 were also similar between the groups. The statin group required significantly less norepinephrine and vasopressin during surgery, and fewer patients in the statin group required vasopressin. There were no significant differences in postoperative outcomes. Conclusions: Acute perioperative statin treatment was not associated with a lower incidence of AKI or improved clinical outcome in patients undergoing valvular heart surgery. (ClinicalTrials.gov NCT01909739).",
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Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery : a randomized, placebo-controlled trial. / Park, Jin Ha; Shim, Jae Kwang; Song, Jong Wook; Soh, Sarah; Kwak, Younglan.

In: Intensive Care Medicine, Vol. 42, No. 9, 01.09.2016, p. 1398-1407.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery

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AU - Park, Jin Ha

AU - Shim, Jae Kwang

AU - Song, Jong Wook

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AU - Kwak, Younglan

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AB - Purpose: Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have the potential to reduce acute kidney injury (AKI) after cardiac surgery through their pleiotropic properties. Here we studied the preventive effect of atorvastatin on AKI after valvular heart surgery. Methods: Two-hundred statin-naïve patients were randomly allocated to receive either statin or placebo. Atorvastatin was administered orally to the statin group according to a dosage schedule (80 mg single dose on the evening prior to surgery; 40 mg on the morning of surgery; three further doses of 40 mg on the evenings of postoperative days 0, 1, and 2). AKI incidence was assessed during the first 48 postoperative hours on the basis of Acute Kidney Injury Network criteria. Results: The incidence of AKI was similar in the statin and control groups (21 vs. 26 %, respectively, p = 0.404). Biomarkers of renal injury including plasma neutrophil gelatinase-associated lipocalin and interleukin-18 were also similar between the groups. The statin group required significantly less norepinephrine and vasopressin during surgery, and fewer patients in the statin group required vasopressin. There were no significant differences in postoperative outcomes. Conclusions: Acute perioperative statin treatment was not associated with a lower incidence of AKI or improved clinical outcome in patients undergoing valvular heart surgery. (ClinicalTrials.gov NCT01909739).

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