A Retrospective Analysis of Statin Use and Outcome After Thoracic Cancer Surgery
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Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
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.
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
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Thoracic sugery statins
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Thoracic surgery non-statins
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
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Effect of perioperative statin use on in-hospital morbidity after thoracic cancer surgery
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Effect of perioperative statin use on the development of Major Adverse Pulmonary Events (MAPE)
Prazo: 30 days after initial surgery
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Includes acute lung injury, acute respiratory distress syndrome, pulmonary embolus, respiratory failure requiring mechanical ventilation and pneumonia
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30 days after initial surgery
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Effect of perioperative statin use and the development of Major Adverse Cardiac Events (MACE)
Prazo: 30 days after initial surgery
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Includes atrial fibrillation, other arrhythmia, myocardial infarction and congestive heart failure.
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30 days after initial surgery
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Effect of perioperative statin on mortality associated with cancer recurrence following thoracic cancer surgery.
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Justin Sandall, D.O., Vanderbilt University
- Diretor de estudo: Mias Pretorius, M.D., Vanderbilt University
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Outros números de identificação do estudo
- 100698
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