# Statinoplaaddosis voor CABG: gerandomiseerde trial

*geplaatst 2023-07-01 · Cholesterol · European heart journal · doi 10.1093/eurheartj/ehad238 · https://hartvaat.nl/2023/07/01/statinoplaaddosis-voor-cabg-gerandomiseerde-trial/*

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.

## English: Statin loading before coronary artery bypass grafting: a randomized trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehad238. Bijgewerkt 2026-07-03T13:29:31Z. 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.