STAR VaS - Short Term Atorvastatin Regime for Vasculopathic Subjects: a randomized placebo-controlled trial evaluating perioperative atorvastatin therapy in noncardiac surgery

Canadian Journal of Anesthesia, 04/16/2012

Neilipovitz DT et al. – Administration of atorvastatin, initiated within seven days preoperatively, was not associated with clinically significant reductions in C–reactive protein (CRP) levels.

Methods

  • In a single centre, parallel group, placebo-controlled trial, sixty high cardiac risk participants over age 45yr undergoing noncardiac surgery were assigned randomly to one of three groups to receive atorvastatin 80mg (A) and/or placebo (P).
  • Group AA (n=26) received atorvastatin seven days before surgery, the day of surgery, and for seven days post surgery.
  • Group PA (n=17) received placebo seven days before surgery, atorvastatin on the day of surgery, and atorvastatin for seven days post surgery.
  • Group PP (n=17) received placebo at all times.
  • All participants, health care professionals, research assistants, and outcome adjudicators were masked to treatment allocation.
  • Analyses were by intention to treat.
  • The primary outcome was the C-reactive protein level at 48hr.

Results

  • Fifty-six participants completed the 30-day follow-up.
  • The mean (standard deviation) changes in CRP levels from baseline at 48hr in Groups AA, PA, and PP were 141.0 (72.4), 153.5 (42.2), and 111.2 (84.6), respectively.
  • The mean differences (95% confidence interval) at 48hr for AA vs PA, AA vs PP, and PA vs PP were: -20.1 (-81.2 to 41.1), 22.7 (-31.7 to 77.2), and 42.8 (-20.0 to 105.7), respectively, adjusting for baseline CRP, type of procedure, presence of coronary artery disease, use of medications, and for multiple comparisons using Tukey’s method.

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