A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery

MD Kertai; Eric Boersma; CM Westerhout; Jan Klein; H van Urk; JJ Bax; Jos Roelandt; D Poldermans

doi:10.1016/j.ejvs.2004.07.008

A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery

MD Kertai
, Eric Boersma
, CM Westerhout
, Jan Klein
, H van Urk
, JJ Bax
, Jos Roelandt
, D Poldermans^*

^*Corresponding author for this work

Erasmus University Medical Centre

Research output: Contribution to journal › Article › Academic › peer-review

201 Citations (Scopus)

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Abstract

Objective.

To investigate the combined beneficial effect of statin and beta-blocker use on perioperative mortality and myocardial infarction (MI) in patients undergoing abdominal aortic aneurysm surgery (AAA).

Background.

Patients undergoing elective AAA-surgery identified by clinical risk factors and dobutamine stress echocardiography (DSE) as being at high-risk often have considerable cardiac complication rate despite the use of betablockers. Methods. We studied 570 patients (mean age 69±9 years, 486 males) who underwent AAA-surgery between 1991 and 2001 at the Erasmus MC. Patients were evaluated for clinical risk factors (age > 70 years, histories of MI, angina, diabetes mellitus, stroke, renal failure, heart failure and pulmonary disease), DSE, statin and beta-blocker use. The main outcome was a composite of perioperative mortality and MI within 30 days of surgery.

Results.

Perioperative mortality or MI occurred in 51 (8.9%) patients. The incidence of the composite endpoint was significantly lower in statin users compared to nonusers (3.7% vs. 11.0%; crude odds ratio (OR): 0.31, 95% confidence interval (CI): 0.13-0.74; pZ0.01). After correcting for other covariates, the association between statin use and reduced incidence of the composite endpoint remained unchanged (OR: 0.24, 95% CI: 0.10-0.70; pZ0.01). Beta-blocker use was also associated with a significant reduction in the composite endpoint (OR: 0.24, 95% CI: 0.11-0.54). Patients using a combination of statins and beta-blockers appeared to be at lower risk for the composite endpoint across multiple cardiac risk strata; particularly patients with 3 or more risk factors experienced significantly lower perioperative events.

Conclusions.

A combination of statin and beta-blocker use in patients with AAA-surgery is associated with a reduced incidence of perioperative mortality and nonfatal MI particularly in patients at the highest risk.

Original language	English
Pages (from-to)	343-352
Number of pages	10
Journal	European Journal of Vascular and Endovascular Surgery
Volume	28
Issue number	4
DOIs	https://doi.org/10.1016/j.ejvs.2004.07.008
Publication status	Published - Oct 2004

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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201 Citations
1 Article

Reprinted Article "a combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery"
Kertai, M. D., Boersma, E., Westerhout, C. M., Klein, J., Van Urk, H., Bax, J. J., Roelandt, J. R. T. C. & Poldermans, D., Sept 2011, In: European Journal of Vascular and Endovascular Surgery. 42, Supplement 1, p. S96-S104
Research output: Contribution to journal › Article › Academic › peer-review
4 Citations (Scopus)

Cite this

Kertai, MD., Boersma, E., Westerhout, CM., Klein, J., van Urk, H., Bax, JJ., Roelandt, J., & Poldermans, D. (2004). A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. European Journal of Vascular and Endovascular Surgery, 28(4), 343-352. https://doi.org/10.1016/j.ejvs.2004.07.008

Kertai, MD ; Boersma, Eric ; Westerhout, CM et al. / A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. In: European Journal of Vascular and Endovascular Surgery. 2004 ; Vol. 28, No. 4. pp. 343-352.

@article{557f7ab4b2384f02bed19a6f0e9a15fe,

title = "A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery",

abstract = "Objective. To investigate the combined beneficial effect of statin and beta-blocker use on perioperative mortality and myocardial infarction (MI) in patients undergoing abdominal aortic aneurysm surgery (AAA). Background. Patients undergoing elective AAA-surgery identified by clinical risk factors and dobutamine stress echocardiography (DSE) as being at high-risk often have considerable cardiac complication rate despite the use of betablockers. Methods. We studied 570 patients (mean age 69±9 years, 486 males) who underwent AAA-surgery between 1991 and 2001 at the Erasmus MC. Patients were evaluated for clinical risk factors (age > 70 years, histories of MI, angina, diabetes mellitus, stroke, renal failure, heart failure and pulmonary disease), DSE, statin and beta-blocker use. The main outcome was a composite of perioperative mortality and MI within 30 days of surgery. Results.Perioperative mortality or MI occurred in 51 (8.9\%) patients. The incidence of the composite endpoint was significantly lower in statin users compared to nonusers (3.7\% vs. 11.0\%; crude odds ratio (OR): 0.31, 95\% confidence interval (CI): 0.13-0.74; pZ0.01). After correcting for other covariates, the association between statin use and reduced incidence of the composite endpoint remained unchanged (OR: 0.24, 95\% CI: 0.10-0.70; pZ0.01). Beta-blocker use was also associated with a significant reduction in the composite endpoint (OR: 0.24, 95\% CI: 0.11-0.54). Patients using a combination of statins and beta-blockers appeared to be at lower risk for the composite endpoint across multiple cardiac risk strata; particularly patients with 3 or more risk factors experienced significantly lower perioperative events. Conclusions.A combination of statin and beta-blocker use in patients with AAA-surgery is associated with a reduced incidence of perioperative mortality and nonfatal MI particularly in patients at the highest risk.",

author = "MD Kertai and Eric Boersma and CM Westerhout and Jan Klein and \{van Urk\}, H and JJ Bax and Jos Roelandt and D Poldermans",

year = "2004",

month = oct,

doi = "10.1016/j.ejvs.2004.07.008",

language = "English",

volume = "28",

pages = "343--352",

journal = "European Journal of Vascular and Endovascular Surgery",

issn = "1078-5884",

number = "4",

}

Kertai, MD, Boersma, E, Westerhout, CM, Klein, J, van Urk, H, Bax, JJ, Roelandt, J & Poldermans, D 2004, 'A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery', European Journal of Vascular and Endovascular Surgery, vol. 28, no. 4, pp. 343-352. https://doi.org/10.1016/j.ejvs.2004.07.008

A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. / Kertai, MD; Boersma, Eric; Westerhout, CM et al.
In: European Journal of Vascular and Endovascular Surgery, Vol. 28, No. 4, 10.2004, p. 343-352.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery

AU - Kertai, MD

AU - Boersma, Eric

AU - Westerhout, CM

AU - Klein, Jan

AU - van Urk, H

AU - Bax, JJ

AU - Roelandt, Jos

AU - Poldermans, D

PY - 2004/10

Y1 - 2004/10

N2 - Objective. To investigate the combined beneficial effect of statin and beta-blocker use on perioperative mortality and myocardial infarction (MI) in patients undergoing abdominal aortic aneurysm surgery (AAA). Background. Patients undergoing elective AAA-surgery identified by clinical risk factors and dobutamine stress echocardiography (DSE) as being at high-risk often have considerable cardiac complication rate despite the use of betablockers. Methods. We studied 570 patients (mean age 69±9 years, 486 males) who underwent AAA-surgery between 1991 and 2001 at the Erasmus MC. Patients were evaluated for clinical risk factors (age > 70 years, histories of MI, angina, diabetes mellitus, stroke, renal failure, heart failure and pulmonary disease), DSE, statin and beta-blocker use. The main outcome was a composite of perioperative mortality and MI within 30 days of surgery. Results.Perioperative mortality or MI occurred in 51 (8.9%) patients. The incidence of the composite endpoint was significantly lower in statin users compared to nonusers (3.7% vs. 11.0%; crude odds ratio (OR): 0.31, 95% confidence interval (CI): 0.13-0.74; pZ0.01). After correcting for other covariates, the association between statin use and reduced incidence of the composite endpoint remained unchanged (OR: 0.24, 95% CI: 0.10-0.70; pZ0.01). Beta-blocker use was also associated with a significant reduction in the composite endpoint (OR: 0.24, 95% CI: 0.11-0.54). Patients using a combination of statins and beta-blockers appeared to be at lower risk for the composite endpoint across multiple cardiac risk strata; particularly patients with 3 or more risk factors experienced significantly lower perioperative events. Conclusions.A combination of statin and beta-blocker use in patients with AAA-surgery is associated with a reduced incidence of perioperative mortality and nonfatal MI particularly in patients at the highest risk.

AB - Objective. To investigate the combined beneficial effect of statin and beta-blocker use on perioperative mortality and myocardial infarction (MI) in patients undergoing abdominal aortic aneurysm surgery (AAA). Background. Patients undergoing elective AAA-surgery identified by clinical risk factors and dobutamine stress echocardiography (DSE) as being at high-risk often have considerable cardiac complication rate despite the use of betablockers. Methods. We studied 570 patients (mean age 69±9 years, 486 males) who underwent AAA-surgery between 1991 and 2001 at the Erasmus MC. Patients were evaluated for clinical risk factors (age > 70 years, histories of MI, angina, diabetes mellitus, stroke, renal failure, heart failure and pulmonary disease), DSE, statin and beta-blocker use. The main outcome was a composite of perioperative mortality and MI within 30 days of surgery. Results.Perioperative mortality or MI occurred in 51 (8.9%) patients. The incidence of the composite endpoint was significantly lower in statin users compared to nonusers (3.7% vs. 11.0%; crude odds ratio (OR): 0.31, 95% confidence interval (CI): 0.13-0.74; pZ0.01). After correcting for other covariates, the association between statin use and reduced incidence of the composite endpoint remained unchanged (OR: 0.24, 95% CI: 0.10-0.70; pZ0.01). Beta-blocker use was also associated with a significant reduction in the composite endpoint (OR: 0.24, 95% CI: 0.11-0.54). Patients using a combination of statins and beta-blockers appeared to be at lower risk for the composite endpoint across multiple cardiac risk strata; particularly patients with 3 or more risk factors experienced significantly lower perioperative events. Conclusions.A combination of statin and beta-blocker use in patients with AAA-surgery is associated with a reduced incidence of perioperative mortality and nonfatal MI particularly in patients at the highest risk.

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U2 - 10.1016/j.ejvs.2004.07.008

DO - 10.1016/j.ejvs.2004.07.008

M3 - Article

C2 - 15350554

SN - 1078-5884

VL - 28

SP - 343

EP - 352

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

IS - 4

ER -

Kertai MD, Boersma E, Westerhout CM, Klein J, van Urk H, Bax JJ et al. A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. European Journal of Vascular and Endovascular Surgery. 2004 Oct;28(4):343-352. doi: 10.1016/j.ejvs.2004.07.008

A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery

Abstract

Bibliographical note

Research programs

UN SDGs

Access to Document

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Research output

Reprinted Article "a combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery"

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