Peri-operative statins

In the DECREASE-III trial, 497 statin-naive patients undergoing elective vascular surgery (carotid, aortic, or lower extremity) were randomized to fluvastatin 80mg or placebo (for 1 month before and 1 month after surgery). The statin group experienced less myocardial ischemia (11% vs 19%) and non-fata MI/CV death (5% vs 10%). Critics state that most of these patients should have been on statins anyway, and that starting peri-operative statins on all vascular surgery patients may not be warranted (abstract).