There is rapidly accumulating data indicating that statins may also reduce the incidence of major cardiovascular adverse events during the perioperative period.

Bruce Perler, M.D., M.B.A., Julius H. Jacobson II Professor of Surgery at the Johns Hopkins University School of Medicine and Chief, Division of Vascular Surgery at Johns Hopkins Hospital, Baltimore, Maryland, reviewed the data from many studies.

According to Dr. Perler, "These data suggest that statins have a significant acute neuroprotective benefit during the perioperative period among patients undergoing CEA. The major benefit of statin therapy is more likely related to several lipidindependent, pleiotropic, effects and this, ultimately, may be responsible for the reduction in stroke incidence."

Dr. Perler presented the following guidelines regarding the use of statins:

-- When To Start: Given that statins appear to provide benefit during the perioperative period through both pleiotropic and lipidlowering mechanisms, it would make sense to start patients as early as possible before their operation.

-- When To Stop: As the majority of patients undergoing vascular surgery can resume oral intake within 24 hours, a reasonable approach might be to restart statin therapy at this time and continue indefinitely unless contraindicated.

-- What Drug And Dosage: There is no convincing data to identify the optimal statin medication for patients undergoing vascular surgical procedures.

Furthermore, future clinical investigation will be helpful to determine the optimal dosing regimen of statin therapy so that vascular surgery patients may achieve the maximum benefit of these medications during the perioperative period.

VEITH SYMPOSIUM - New York, November 19th to 23rd

Now in its fourth decade, VEITH SYMPOSIUM provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features rapid-fire presentations from world renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.

VEITHsymposium is sponsored by Cleveland Clinic, Cleveland, OH.


Pauline T. Mayer

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