{"id":"94a011d56a1a","type":"article","url":"https://hartvaat.nl/2023/07/01/statinoplaaddosis-voor-cabg-gerandomiseerde-trial/","title":"Statinoplaaddosis voor CABG: gerandomiseerde trial","title_en":"Statin loading before coronary artery bypass grafting: a randomized trial.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog"],"tags":["newton-cabg"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehad238","source_url":"https://doi.org/10.1093/eurheartj/ehad238","authors":["Oliver J Liakopoulos","Elmar W Kuhn","Martin Hellmich","Markus Schlömicher","Justus Strauch","Wilko Reents","Anno Diegeler","Matthias Thielmann","Daniel Wendt","Jochen Börgermann","Jan F Gummert","Christian Stoppe","Andreas Goetzenich","Sven Martens","Hermann Reichenspurner","Jens Wippermann","Hannes Reuter","Yeong-Hoon Choi","Thorsten Wahlers"],"significance":6,"published":"2023-07-01","source_date":"2023-07-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/ezetimib/","https://hartvaat.nl/kennis/lipiden/omega3-vetzuren-cardiologie/"],"congress":"","summary_en":"This randomized trial showed that high-dose statin loading before CABG does not improve outcomes, in contrast to the proven benefit before PCI, suggesting different mechanisms of perioperative benefit between surgical and percutaneous revascularization.","created":"2026-07-03T10:30:27Z","updated":"2026-07-03T13:29:31Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial onderzocht of een hoge statinoplaaddosis vóór CABG de uitkomsten verbetert. In tegenstelling tot bij PCI was er geen significant voordeel van preoperatieve statineloading bij bypasschirurgie.","abstract_original":"AIMS: Evidence suggests that a high-dose statin loading before a percutaneous coronary revascularization improves outcomes in patients receiving long-term statins. This study aimed to analyse the effects of such an additional statin therapy before surgical revascularization. METHODS AND RESULTS: This investigator-initiated, randomized, double-blind, and placebo-controlled trial was conducted from November 2012 to April 2019 at 14 centres in Germany. Adult patients (n = 2635) with a long-term statin treatment (≥30 days) who were scheduled for isolated coronary artery bypass grafting (CABG) were randomly assigned to receive a statin-loading therapy or placebo at 12 and 2 h prior to surgery using a web-based system. The primary outcome of major adverse cardiac and cerebrovascular events (MACCE) was a composite consisting of all-cause mortality, myocardial infarction (MI), and a cerebrovascular event occuring within 30 days after surgery. Key secondary endpoints included a composite of cardiac death and MI, myocardial injury, and death within 12 months. Non-statistically relevant differences were found in the modified intention-to-treat analysis (2406 patients; 1203 per group) between the statin (13.9%) and placebo groups (14.9%) for the primary outcome [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.74-1.18; P = 0.562] or any of its individual components. Secondary endpoints including cardiac death and MI (12.1% vs. 13.5%; OR 0.88, 95% CI 0.69-1.12; P = 0.300), the area under the troponin T-release curve (median 0.398 vs. 0.394 ng/ml, P = 0.333), and death at 12 months (3.1% vs. 2.9%; P = 0.825) were comparable between treatment arms. CONCLUSION: Additional statin loading before CABG failed to reduce the rate of MACCE occuring within 30 days of surgery."}