ArticleResearch in heart yield and translational medicine2025
The Effect of High-Dose Atorvastatin on Postoperative Troponin in Patients Undergoing Non-Cardiac Surgery: A Triple-Blind Randomized Clinical Trial.
Article in Research in heart yield and translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Highlights: Preoperative administration of high-dose statins in patients undergoing non-cardiac surgery reduced postoperative troponin. Background: Cardiovascular complications account for a substantial proportion of perioperative complications. This study aimed to evaluate whether preoperative high-dose atorvastatin reduces postoperative changes in serum high-sensitivity cardiac troponin (hscTn) concentrations in patients at elevated cardiac risk undergoing noncardiac surgery. Methods: In this triple-blind, parallel-group, randomized controlled trial, adults with a Revised Cardiac Risk Index (RCRI) of 1 or greater scheduled for noncardiac surgery were randomized (1:1) to receive atorvastatin 80 mg 24 hours preoperatively or placebo. The primary outcome was the change in serum hs-cTn concentrations 24 hours after surgery. Secondary outcomes included the incidence of major adverse cardiovascular events (MACE) within 7 days after surgery, as well as cardiovascular death, myocardial infarction, stroke, heart failure, arrhythmia, or transient ischemic attack. Results: A total of 112 patients with similar baseline characteristics were randomized and completed a 7-day follow-up. Postoperative hs-cTn levels increased significantly in the placebo group (P<0.001) but decreased in the statin group (P<0.001), with a significant between-group difference favoring statin therapy (P<0.001). Subgroup analyses by anesthesia type and prior statin use showed consistent findings. MACE occurred in three patients (5.4%) in the statin group and two patients (3.6%) in the placebo group (P=1.00). Conclusion: Preoperative high-dose atorvastatin significantly reduced postoperative hs-cTn levels, indicating a biochemical cardioprotective effect, but it did not translate into a reduction of short-term clinical cardiovascular events. Larger multicenter trials with longer follow-up are required to determine whether troponin reduction translates into improved clinical outcomes.
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