***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Statins are powerful lipid-lowering drugs that have been proved effective in the prevention of coronary artery disease , clearly reducing the risk of mortality and cardiovascular events . Whether hyperlipidemic patients undergoing coronary artery bypass grafting profit from the lipid-lowering beneficial effects of statins is as yet uncertain . We sought to determine whether preoperative statin therapy may have an effect on outcome among hyperlipidemic patients undergoing coronary artery bypass grafting .  METHODS From January 2000 through March 2006 , prospect ively recorded clinical data from 3346 consecutive patients undergoing isolated first-time elective coronary artery bypass grafting  were analyzed for major adverse cardiac events and all-cause in-hospital mortality . Of these , 167 patients had preoperative statin-untreated hyperlipidemia ( group 1 ) , 2592 had statin-treated hyperlipidemia ( group 2 ) , and 587 had statin-untreated normolipidemia ( group 3 ) . RESULTS Risk-adjusted multivariate logistic regression analysis revealed statin-treated hyperlipidemia ( odds ratio , 0.42 ; 95 % confidence interval , 0.26 - 0.69 ; P = .0007 ) and statin-untreated normolipidemia ( odds ratio , 0.42 ; confidence interval , 0.26 - 0.69 ; P = .0007 ) to be independently associated with reduced in-hospital major adverse cardiac events but not with in-hospital mortality . To further control for selection bias , a computed propensity score matching based on 14 major preoperative risk factors was performed . After propensity matching , conditional logistic regression analysis confirmed statin-treated hyperlipidemia and statin-untreated normolipidemia to be strongly related to reduced in-hospital major adverse cardiac events ( odds ratio , 0.41 ; 95 % confidence interval , 0.24 - 0.71 [ P = .0013 ] and odds ratio , 0.23 ; 95 % confidence interval , 0.11 - 0.48 [ P = .0001 ] ) but not with in-hospital mortality ( odds ratio , 1.18 ; 95 % confidence interval , 0.36 - 3.87 [ P = .79 ] and odds ratio , 1.10 ; 95 % confidence interval , 0.32 - 4.41 [ P = .80 ] ) after coronary artery bypass grafting surgery . CONCLUSIONS Hyperlipidemic , but not normolipidemic , patients have an increased risk for in-hospital major adverse cardiac events and therefore clearly benefit from preoperative statin therapy before coronary artery bypass grafting surgery OBJECTIVE Statin therapy in ambulatory population s is associated with a significant reduction in adverse cardiovascular events , including death and myocardial infa rct ion . Much less is known about the beneficial effects of statins on acute perioperative cardiovascular events . The purpose of this study was to determine whether preoperative statin therapy is associated with a reduced risk of early cardiac death or nonfatal , in-hospital postoperative myocardial infa rct ion after primary , elective coronary artery bypass graft surgery requiring cardiopulmonary bypass . METHODS The Multicenter Study of Perioperative Ischemia ( McSPI ) Epidemiology II Study was a prospect i ve , longitudinal study of 5436 patients undergoing coronary artery bypass graft surgery between November 1996 and June 2000 at 70 centers in 17 countries . The present study consisted of a pre-specified subset of these subjects divided into patients receiving ( n = 1352 ) and not receiving ( n = 1314 ) preoperative statin therapy . To control for potential bias related to use of statin therapy , the study estimated propensity scores by logistic regression to determine the predicted probability of inclusion in the " statin " group . Multivariate , stepwise logistic regression was then performed , controlling for patient demographics , medical history , operative characteristics , and propensity score to determine whether preoperative statin therapy was independently associated with a reduction in the risk of early ( DOS-POD3 ) cardiac death and /or nonfatal , in-hospital postoperative myocardial infa rct ion . RESULTS Preoperative statin therapy was independently associated with a significant reduction ( adjusted odds ratio [ OR ] 0.25 ; 95 % confidence intervals [ CI ] 0.07 - 0.87 ) in the risk of early cardiac death after primary , elective coronary bypass surgery ( 0.3 % vs 1.4 % ; P < .03 ) , but was not associated with a reduced risk of postoperative nonfatal , in-hospital myocardial infa rct ion ( 7.9 % vs 6.2 % ; P = not significant ) . Discontinuation of statin therapy after surgery was independently associated with a significant increase in late ( POD4-discharge ) all-cause mortality ( adjusted OR 2.64 ; 95 % CI 1.32 - 5.26 ) compared with continuation of statin therapy ( 2.64 % vs 0.60 % ; P < .01 ) . This was true even when controlling for the postoperative discontinuation of aspirin , beta-blocker , or angiotensin-converting enzyme inhibitor therapy . Discontinuation of statin therapy after surgery was also independently associated with a significant increase in late cardiac mortality ( adjusted OR 2.95 ; 95 % CI 1.31 - 6.66 ) compared with continuation of statin therapy ( 1.91 % vs 0.45 % ; P < 0.01 ) . CONCLUSIONS Preoperative statin use is associated with reduced cardiac mortality  after primary , elective coronary artery bypass grafting . Postoperative statin discontinuation is associated with increased in-hospital mortality . Although further r and omized trials are needed to confirm these findings , these data suggest the importance of perioperative statin administration BACKGROUND The beneficial effects of 3-hydroxy-3-methylglutaryl coenzyme A ( HMG Co-A ) reductase inhibitors ( statins ) in patients undergoing coronary artery bypass grafting have been recognized . Reduced mortality rates and clinical events have been demonstrated . These outcomes were examined in patients taking statins who underwent cardiac valve operations . METHODS This retrospective study included 447 consecutive patients undergoing valve operations between July 2004 and February 2006 ; 203 patients ( 45.6 % ) received statins preoperatively and postoperatively vs 244 who did not . Preoperative risk factors and outcome data for both cohorts were compared . Primary outcomes included 30-day mortality , renal failure , and postoperative stroke . RESULTS The  statin group had more comorbidities . Although they had increased risk factors , including previous stroke ( 30 of 203 vs 16 of 244 , p = 0.004 ) , diabetes ( 66 of 203 vs 32 of 244 , p < 0.0001 ) , cerebrovascular disease ( 45 of 203 vs 24 of 244 , p = 0.003 ) , and dyslipidemia ( 191 of 203 vs 63 of 244 , p < 0.0001 ) , they had better outcomes . The unadjusted odds ratio ( OR ) for the composite end point of death/stroke/renal failure was 1.90 ( 95 % confidence interval [ CI ] , 0.95 to 3.76 ; p = 0.068 ) favoring the statin group . By univariate analysis , the adjusted OR for the composite end point demonstrated a benefit with statin therapy : diabetes , 2.29 ( 95 % CI , 1.16 to 4.71 ; p = 0.024 ) ; stroke , 2.15 ( 95 % CI , 1.06 to 4.35 ; p = 0.034 ) ; and renal dysfunction , 2.05 ( 95 % CI , 1.02 to 4.13 ; p = 0.045 ) . CONCLUSIONS Statin therapy in this population undergoing cardiac valve procedures was associated with decreased postoperative morbidity and death . The mechanism may be independent of statins ' lipid-lowering effects . A prospect i ve , r and omized-control trial of statin therapy in this population is warranted Background — Atrial fibrillation ( AF ) after cardiac surgery is associated with increased risk of complications , length of stay , and cost of care . Observational evidence suggests that patients who have undergone previous statin therapy have a lower incidence of postoperative AF . We tested this observation in a r and omized , controlled trial . Methods and Results — Two hundred patients undergoing elective cardiac surgery with cardiopulmonary bypass , without previous statin treatment or history of AF , were enrolled . Patients were r and omized to atorvastatin ( 40 mg/d , n=101 ) or placebo  ( n=99 ) starting 7 days before operation . The primary end point was incidence of postoperative AF ; secondary end points were length of stay , 30-day major adverse cardiac and cerebrovascular events , and postoperative C-reactive protein ( CRP ) variations . Atorvastatin significantly reduced the incidence of AF versus placebo ( 35 % versus 57 % , P=0.003 ) . Accordingly , length of stay was longer in the placebo versus atorvastatin arm ( 6.9±1.4 versus 6.3±1.2 days , P=0.001 ) . Peak CRP levels were lower in patients without AF ( P=0.01 ) , irrespective of r and omization assignment . Multivariable analysis showed that atorvastatin treatment conferred a 61 % reduction in risk of AF ( odds ratio 0.39 , 95 % confidence interval 0.18 to 0.85 , P=0.017 ) , whereas high postoperative CRP levels were associated with increased risk ( odds ratio 2.0 , 95 % confidence interval 1.2 to 7.0 , P=0.01 ) . The incidence of major adverse cardiac and cerebrovascular events at 30 days was similar in the 2 arms . Conclusions — Treatment with atorvastatin 40 mg/d , initiated 7 days before surgery , significantly reduces the incidence of postoperative AF after elective cardiac surgery with cardiopulmonary bypass and shortens hospital stay . These results may influence practice patterns with regard to adjuvant pharmacological therapy before cardiac surgery OBJECTIVE It has earlier been suggested that postoperative thrombocytosis frequently occur after coronary artery  bypass grafting ( CABG ) and may be linked to lipid disturbances . A prospect i ve r and omized study was undertaken to evaluate if preoperative lipid-control , using HMG-CoA-reductase inhibitor ( Zocor ) , simvastatin , reduces the risk of postoperative thrombocytosis . METHODS Seventy-seven patients with symptomatic coronary artery disease and hypercholesterolemia ( total cholesterol > or = 6.2 mmol/l ) , planned for CABG where r and omly assigned to ; undergo CABG without preoperation lipid control ( group I , n = 37 ) or undergo simvastatin-treatment ( 20 mg daily ) to control their lipids ( 4 weeks ) prior to CABG ( group II , n = 40 ) . RESULTS Patient characteristics and operation data did not differ between the groups . Serum-cholesterol , cholesterol/HDL-cholesterol , LDL-cholesterol , Apolipoprotein A1 and Plasminogen were all significantly higher in group I patients compared with group II just prior to surgery . Other laboratory parameters did not differ . RESULTS In group II , total cholesterol and cholesterol/HDL-cholesterol quota were significantly lowered by simvaststin ( -2 and -29 % , respectively ) . Postoperative thrombocytosis ( platelet counts > or = 400000/microl ) occurred significantly more frequently in group I 81 % ( 30/37 ) compared with 3 % ( 1/40 ) in group II , P<0.0001 . Myocardial infa rct ion after the 7th postoperative day was more often diagnosed in group I , 14 vs. 0 % in group II . Postoperative transient renal failure occurred also more frequently in group I , 24 % compared with 8 % in group II . Other postoperative complications and laboratory data did not differ . CONCLUSIONS This study once again underlines the importance of lipid control using HMG-CoA-reductase inhibitors ( e.g. Zocor ) in patients with established coronary artery disease . For the first time it is shown that lipid-control with simvastatin prior to CABG reduces the risk of postoperative thrombocytosis , thus lowers the risk for thrombotic complications OBJECTIVE To determine if preoperative statin treatment is associated with a reduction in systemic inflammatory response ( SIR ) and myocardial damage markers following cardiac surgery with cardiopulmonary bypass ( CPB ) . METHODS We study a prospect i ve cohort of 138 patients who underwent coronary and valvular surgery with CPB .  We differentiate two study groups : patients with ( group A , n=72 ) or  without ( group B , n=66 ) statins . 
    Output:
    
No statistical differences were found between groups with regard to myocardial infa rct ion or renal failure .
In conclusion , the current systematic review strengthens the evidence that preoperative statin therapy extends substantial clinical benefit to early postoperative outcomes in cardiac surgery patients