Statins (HMG-CoA reductase inhibitors) are a widely used class of cholesterol-lowering drugs
that have an established role in the medical management of cardiovascular disease. Their
benefits have also been shown in the surgical setting with decreased cardiovascular
complications and lower perioperative mortality following cardiac and vascular surgery. There
is now considerable evidence showing statins have useful pleiotropic properties that extend
beyond cholesterol lowering, including anti-inflammatory, anti-oxidant, immunomodulatory and
fibrinolytic effects. Growing evidence suggests these effects may be useful in attenuating
the proinflammatory and metabolic stress response to surgery and the benefit of statins may
extend to other surgical settings such as abdominal surgery.
Laboratory studies demonstrate the surgically-relevant benefits of statins and show they
decrease peritoneal inflammation, reduce the severity of intestinal ischaemia-reperfusion
injury, improve survival in models of abdominal sepsis, decrease the formation of
postoperative intraperitoneal adhesions and improve the healing of colonic anastomoses.
Retrospective clinical studies show statins improve outcomes in sepsis, reduce the
postoperative systemic inflammatory response syndrome (SIRS) and are associated with
decreased rates of surgical wound infections and postoperative respiratory complications
following various non-cardiac general surgical procedures. However, no prospective studies
have specifically evaluated the perioperative use of statins in abdominal surgery. Using
colorectal surgery as a model for major abdominal surgery, the investigators will conduct a
randomised controlled trial evaluating the effect of perioperative statin use on
postoperative morbidity, local and systemic inflammatory response, and functional recovery
after surgery.
Phase:
Phase 3
Details
Lead Sponsor:
University of Auckland, New Zealand
Collaborators:
Auckland District Health Board Counties Manukau Health Waitemata District Health Board