A Retrospective Analysis of Statin Use and Outcome After Thoracic Cancer Surgery
調査の概要
状態
詳細な説明
Statins are well established for the use of primary and secondary prevention of cardiovascular disease. Moreover, there is increasing evidence that statins have numerous effects separate from their lipid lowering properties-pleiotropic effects. These pleiotropic effects, including a reduction in the inflammatory response and improved endothelial function, may improve perioperative outcomes via modulation of the surgical stress response. Improved perioperative outcomes have been demonstrated in patients undergoing vascular, cardiac and non-cardiovascular surgery. Specific to the thoracic surgery population, statin use has been reported to reduce the incidence of atrial fibrillation.
Statins, via inhibition of the rate limiting step of the mevalonate pathway, have also sparked interest in their potential anticancer effects as well as in cancer prevention. There is some evidence for anticancer effects of statins in patients with esophageal and lung cancer. Additionally, other agents with known anti-inflammatory effects also point to the potential for improved outcome in cancer patients. In this regard, aspirin use is reported to associate with prolonged survival in breast cancer patients, while perioperative use of anti-inflammatory agents (COX-II inhibitor use and lung cancer; aprotinin use and mesothelioma; aprotinin use and esophageal cancer) is associated with improved postoperative survival. Moreover, the use of regional analgesia is commonly employed in the thoracic surgery population and has been associated with attenuation of metastasis and improvement in recurrence rates for some types of cancers.
In a prospective pilot study of patients undergoing elective thoracic surgery, a collaborative member of our group recently found that patients suffering postoperative complications had poorer endothelial function, as measured by flow mediated dilation. Those patients with poorer endothelial function had greater wound healing complications (6% vs. 0%, p=0.01), longer ICU length of stay (4 vs. 0.9 days, p=0.02), and longer hospital length of stay (14 vs. 6.9 days, p=0.01). Although this pilot study was underpowered to demonstrate a significant correlation between Brachial Artery Reactivity Testing (BART) derived endothelial function and "all" postoperative complications, it provides hypothesis generating data and supports the hypothesis that statins, as modulators of endothelial function, may have a role in improving postoperative outcome.
研究の種類
入学 (実際)
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
This study is a retrospective chart review of adult thoracic surgery patients who underwent:
- Esophagectomy
- Pulmonary wedge resection
- Pulmonary lobectomy
- Pulmonary pneumonectomy
Data collected will be from January 1, 2007 forward.
説明
Inclusion Criteria:
This study is a retrospective chart review of adult thoracic surgery patients who underwent:
- Esophagectomy
- Pulmonary wedge resection
- Pulmonary lobectomy
- Pulmonary pneumonectomy
Data collected will be from January 1, 2007 forward
Exclusion Criteria:
None
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
---|
Thoracic sugery statins
|
Thoracic surgery non-statins
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
---|
Effect of perioperative statin use on in-hospital morbidity after thoracic cancer surgery
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Effect of perioperative statin use on the development of Major Adverse Pulmonary Events (MAPE)
時間枠:30 days after initial surgery
|
Includes acute lung injury, acute respiratory distress syndrome, pulmonary embolus, respiratory failure requiring mechanical ventilation and pneumonia
|
30 days after initial surgery
|
Effect of perioperative statin use and the development of Major Adverse Cardiac Events (MACE)
時間枠:30 days after initial surgery
|
Includes atrial fibrillation, other arrhythmia, myocardial infarction and congestive heart failure.
|
30 days after initial surgery
|
Effect of perioperative statin on mortality associated with cancer recurrence following thoracic cancer surgery.
|
協力者と研究者
捜査官
- 主任研究者:Justin Sandall, D.O.、Vanderbilt University
- スタディディレクター:Mias Pretorius, M.D.、Vanderbilt University
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 100698
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