Lipid-Lowering Therapy and In-Hospital Mortality Following Major Noncardiac Surgery

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Abstract
Approximately 24 million surgical operations are performed each year at hospitals across the United States1 and it is estimated that as many as 1 million of these operations will be complicated by a perioperative cardiovascular event.2 Perioperative myocardial infarction is a dreaded occurrence that is associated with prolonged hospital stay, substantial morbidity, and mortality rates as high as 25% to 40%.3,4 Among patients undergoing major noncardiac surgery, the overall incidence of perioperative myocardial infarction is 2% to 3%, and within high-risk populations, such as those patients undergoing vascular surgery, rates can be as high as 34%.5,6 Although clinical prediction instruments5,7-9 have improved the ability to detect patients at risk of perioperative cardiac events, effective prevention strategies remain limited.10 The emergence of perioperative β-blockade appears to be a major therapeutic advance,11,12 yet rates of perioperative cardiovascular complications among the highest-risk patients treated with β-blockers can reach 16%.13,14 Additional prevention modalities are therefore still needed to improve patient safety and outcomes following surgery.

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