The effect of preoperative statins on postoperative mortality, renal, and neurological complications in patients undergoing cardiac surgeries: a retrospective cohort study.

BACKGROUND: Cardiac surgery is performed worldwide to treat severe cases of cardiovascular diseases. Statins have shown controversial effects on complications after cardiac surgeries. We aimed to investigate the effect of preoperative statin therapy on the frequency of postoperative mortality, renal, and neurological complications. METHODS: In a retrospective cohort study, the database of patients operated on in two hospitals in southern Iran during 2008-2019 was used to compare preoperative statin use with no use on the composite outcome of mortality, renal, and neurological complications as well as on each component of the composite, separately. Effects of low dose (<40 mg simvastatin equivalence) vs. high dose (≥40 mg) statins were also evaluated. Confounders that could affect the outcomes were considered in the logistic regression model, and multiple imputation techniques were used to categorize patients with unknown statin dose use as either high or low-dose users. RESULTS: Of total 7329 patients, 17.6% of statin users and 17% of non-statin users developed the composite outcome (P=0.51). Statin use had no statistically significant association with the composite outcome (aRR 1.01 [95% CI: 0.88-1.16]). There was no significant association with mortality [aRR: 0.75 (95% CI: 0.34-1.69)], neurological [aRR: 1.25 (95% CI: 0.77-2.12)], or renal complications [aRR: 1.03 (95% CI 0.90-1.19)] after surgery. Neither low nor high doses had any statistically significant effect on the composite or any of its components. CONCLUSIONS: In this large study, preoperative statin use, either high dose or low dose, did not affect short-term postoperative mortality, neurological, or renal complications.

The impact of coronary artery bypass graft surgery on depression and anxiety.

AIMS: Psychiatric disorders, including depression and anxiety, after coronary artery bypass graft (CABG) surgery are rife. Such disorders can make important impacts on patients. We aimed to evaluate the value of the surgical approach, associated with other medical therapies in decreasing depression and anxiety in a group of patients scheduled for CABG in our center. METHODS: In a prospective study, all patients scheduled for CABG in a 6-month period were selected consecutively to enter a two-stage study. The patients were interviewed using Hamilton Depression and Anxiety Rating Scales before and 4 weeks after the operations. RESULTS: Mean age of men in the anxiety group (68 patients) was significantly lower than that of women. Mean anxiety scores before and after the operations were 8.9 ± 4.7 and 6.7 ± 4.4, respectively (P = 0.026). Mean age of women in the depression group (55 patients) was more than that of men (P = 0.04). Mean scores of depression before and after the operations were 13.30 ± 7.59 and 11.2 ± 7.19, respectively (P = 0.027). Men's scores of anxiety and depression were decreased significantly more than those in women after operations. CONCLUSION: CABG surgery can decrease the level of anxiety and depression in patients scheduled for surgery in a short-term follow-up. This effect is more prominent in men than women.