Preoperative Statin Use Associated With Lower One-Year Mortality After Non-Cardiac Surgery

An observational study in the European Journal of Preventive Cardiology examined established preoperative statin therapy among 56,362 patients aged ≥45 years undergoing non-cardiac surgery at two university hospitals during 2016–2023. Primary outcomes were 30- and 365-day mortality. Researchers used propensity-score weighting to balance measured confounders and weighted Cox regression to compare statin exposure and treatment intensity.

Overall, 372 patients (0.6%) died within 30 days and 3,735 (6.6%) within 365 days. Statin use was associated with lower 365-day mortality (hazard ratio [HR] 0.81; 95% CI 0.73–0.90), with a reported absolute risk difference of −1.2 percentage points. The association with 30-day mortality was not statistically significant (HR 0.78; 95% CI 0.57–1.07). Compared with no statin, high-intensity therapy was associated with a lower one-year mortality hazard (HR 0.71; 95% CI 0.60–0.83; absolute risk difference −2.3 percentage points), as was low/intermediate-intensity therapy (HR 0.84; 95% CI 0.74–0.96).

The findings support further evaluation of perioperative statin continuation, rather than establishing benefits from starting treatment before surgery. Although sensitivity analyses were consistent, the observational design cannot establish causality or exclude unmeasured confounding. The authors call for randomized confirmation. Only the abstract was available for this assessment.