Universität zu Köln

Liakopoulos, Oliver J., Kuhn, Elmar W., Hellmich, Martin, Kuhr, Kathrin, Krause, Petra, Reuter, Hannes, Thurat, Meike, Choi, Yeong-Hoon and Wahlers, Thorsten (2015). Statin Recapture Therapy before Coronary Artery Bypass Grafting Trial: Rationale and study design of a multicenter, randomized, double-blinded controlled clinical trial. Am. Heart J., 170 (1). S. 46 - 57. NEW YORK: MOSBY-ELSEVIER. ISSN 1097-5330

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Abstract

Introduction Patients undergoing coronary artery bypass grafting (CABG) are still at significant risk for postoperative major adverse cardiac and cerebrovascular events (MACCEs). Recent clinical evidence shows that cardioprotection in patients receiving a chronic statin treatment can be recaptured by a high-dose statin therapy given shortly before an ischemia-reperfusion sequence. Evaluation of this novel therapeutic approach in the setting of CABG seems promising because myocardial ischemia-reperfusion injury plays a pivotal role in poor clinical outcomes that may be improved by a simple preoperative statin recapture treatment. Methods The investigator-initiated StaRT-CABGtrial is a multicenter, randomized, double-blinded, 2-parallel group controlled clinical study in 2,630 patients. The trial aims to evaluate whether a high-dose statin recapture therapy given shortly before CABG reduces the incidence of MACCE at 30 days after surgery (primary composite outcome: all-cause mortality, nonfatal myocardial infarction, and cerebrovascular events). Consenting patients who are on chronic statin therapy before surgery will be randomized to receive either oral statin reloading therapy or matching placebo 12 and 2 hours before CABG. Key secondary end points include enzymatic myocardial injury; new-onset atrial fibrillation; length of stay in the intensive care unit and hospital; need for repeat coronary revascularization at 30 days; and, finally, all-cause mortality at 12 months after surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Thurat, Meike UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-400145
DOI:	10.1016/j.ahj.2015.04.015
Journal or Publication Title:	Am. Heart J.
Volume:	170
Number:	1
Page Range:	S. 46 - 57
Date:	2015
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1097-5330
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HYDROGEN EXCHANGE INHIBITION; CARDIAC TROPONIN-T; CARDIOVASCULAR RISK; MYOCARDIAL DAMAGE; SURGERY; INTERVENTION; ATORVASTATIN; METAANALYSIS; PRETREATMENT; EFFICACY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40014