Effects of preoperative statin on acute kidney injury after off-pump coronary artery bypass grafting

Abstract

Background-Although many patients with coronary artery disease are using statins before off-pump coronary artery bypass grafting (OPCAB) following current guidelines, recent studies have raised concerns regarding adverse effects of preoperative statins on postoperative kidney function. We evaluated the effects of preoperative statins on acute kidney injury (AKI) after OPCAB. Methods and Results-We enrolled 1783 consecutive OPCAB patients in either a statin or nonstatin group based on preoperative use of statins. Propensity scores were used to adjust the differences between the groups. The primary outcome was incidence of postoperative AKI according to Kidney Disease: Improving Global Outcomes criteria. To evaluate the dose-related renal effects of statins, the statin group was divided into low- and moderate- or higher dose groups based on preoperative statin dose. The incidence of postoperative AKI was 15.7% and 13.5% in the nonstatin and statin groups, respectively, and preoperative statins did not increase the incidence of postoperative AKI (odds ratio: 0.84; 95% CI, 0.61-1.15; P=0.27). In dose-related analysis, the moderate- or higher dose group showed lower incidence of postoperative AKI in comparison with the nonstatin group (odds ratio: 0.61; 95% CI, 0.39-0.95; P=0.03). However, no difference was found between low-dose and nonstatin groups (odds ratio: 1.17; 95% CI, 0.75-1.84; P=0.49) or between moderate- or higher dose and low-dose statin groups (odds ratio: 0.84; 95% CI, 0.5-1.41; P=0.51) in the incidence of postoperative AKI. Conclusions-Neither preoperative statin use nor statin dose increased the risk of AKI after OPCAB. Preoperative statin therapy is not harmful in patients receiving OPCAB.