TY - JOUR
T1 - Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation
AU - Raphael, Jacob
AU - Collins, Stephen R.
AU - Wang, Xin Qun
AU - Scalzo, David C.
AU - Singla, Priyanka
AU - Lau, Christine L.
AU - Kozower, Benjamin D.
AU - Durieux, Marcel E.
AU - Blank, Randal S.
N1 - Publisher Copyright:
© 2017 International Society for the Heart and Lung Transplantation
PY - 2017/9
Y1 - 2017/9
N2 - Background Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. Methods We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System. The primary outcome was PGD (grades 1-3). Secondary outcomes included grade 3 PGD, length of intensive care unit and hospital stay, and mortality. Results Of 266 patients who met final inclusion criteria, 138 (52%) were diagnosed with PGD. In-hospital mortality among patients with PGD was 6.5%. There were no deaths in patients without PGD (p < 0.001). PGD was diagnosed in 24 patients taking statins (34.8%) and in 114 patients (57.9%) who did not take statins (p = 0.001). After propensity score adjustments, perioperative statin use was independently associated with a reduced risk for PGD (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20–0.84, p = 0.015) and reduced risk to develop grade 3 PGD (OR 0.42, 95% CI 0.18–0.94, p = 0.036). Other risk factors associated with PGD included intraoperative use of cardiopulmonary bypass (OR 3.74, 95% CI 1.75–8.02, p = 0.001) and positive donor smoking status (OR 2.27, 95% CI 1.18–4.35, p = 0.014). Conclusions The results demonstrate that perioperative use of statins is independently associated with reduced risk for PGD after lung transplantation.
AB - Background Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. Methods We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System. The primary outcome was PGD (grades 1-3). Secondary outcomes included grade 3 PGD, length of intensive care unit and hospital stay, and mortality. Results Of 266 patients who met final inclusion criteria, 138 (52%) were diagnosed with PGD. In-hospital mortality among patients with PGD was 6.5%. There were no deaths in patients without PGD (p < 0.001). PGD was diagnosed in 24 patients taking statins (34.8%) and in 114 patients (57.9%) who did not take statins (p = 0.001). After propensity score adjustments, perioperative statin use was independently associated with a reduced risk for PGD (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20–0.84, p = 0.015) and reduced risk to develop grade 3 PGD (OR 0.42, 95% CI 0.18–0.94, p = 0.036). Other risk factors associated with PGD included intraoperative use of cardiopulmonary bypass (OR 3.74, 95% CI 1.75–8.02, p = 0.001) and positive donor smoking status (OR 2.27, 95% CI 1.18–4.35, p = 0.014). Conclusions The results demonstrate that perioperative use of statins is independently associated with reduced risk for PGD after lung transplantation.
KW - lung transplantation
KW - mortality
KW - outcomes
KW - primary graft dysfunction
KW - statins
UR - http://www.scopus.com/inward/record.url?scp=85019831785&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2017.05.007
DO - 10.1016/j.healun.2017.05.007
M3 - Article
C2 - 28552627
AN - SCOPUS:85019831785
SN - 1053-2498
VL - 36
SP - 948
EP - 956
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 9
ER -