What Statins Might Do for Lung Surgery Patients

Statins may reduce major lung surgery complications

(RxWiki News) A common cholesterol medication may make lung surgery a little bit safer.

Although it was cut short due to trouble finding participants who had never taken statins, a new study found that these cholesterol-lowering drugs held promise for reducing complications after lung surgery. The findings of this study were not statistically significant, but a later expert review of research on this topic also found that statins could reduce complications for patients after lung surgery.

Lead study author David Amar, MD, of Memorial Sloan Kettering Cancer Center in New York, and colleagues set out to see whether statins (brand names like Lipitor, Zocor and Crestor) could reduce complications after lung resection surgery, in which a portion of the lung is removed due to lung cancer or lung disease. Complications included post-surgery problems like pneumonia, respiratory failure, atrial fibrillation (irregular heart rate), heart attack, blood clots and death.

These researchers studied both patients who took statins and those who had never taken the drugs. Dr. Amar and team wanted to enroll at least 480 patients in their study, but partially because statins were so commonly used, especially among those in need of thoracic surgery like lung resection, they could only find 164 patients.

As a result, Dr. Amar and team had to cut their study short, but before they did, they found that complications after surgery occurred for 22 percent of the patients who received a fake pill (placebo). For those who took statins, that rate was 12 percent.

While statins appeared to nearly cut the risk in half, Dr. Amar and team determined that these results were not statistically significant due to several factors, including the small number of patients. However, for lung resections that removed large portions of the lung, statins appeared to have a greater effect on post-surgery safety, particularly for the risk of atrial fibrillation.

Dr. Amar and team theorized that statins' anti-inflammatory effects could help keep patients healthy after surgery.

A later review of past research on this topic, written by Neel R. Sodha, MD, and Frank W. Selke, MD, both of Alpert Medical School at Brown University, found similar results.

“A review of the research shows that slightly more than half the studies [done for cardiac surgery] support the anti-inflammatory effect of statins," Drs. Sodha and Selke wrote in their review. "Clinical studies are confounded because most patients proceeding to cardiac or thoracic surgery are receiving statins to reduce the progression of coronary artery disease. Therefore, it is difficult to know whether statins also reduce postoperative complications. Conclusions regarding the relationship of statins to clinical outcomes cannot be drawn based on current data."

And because researchers aren't yet at the point where they can recommend statins for patients undergoing lung surgery, they called for further research on the topic.

In an editorial about the study by Dr. Amar and team, Betty C. Tong, MD, of Duke University Medical Center, lamented the fact that this study was stopped short and had inconclusive findings.

"Imagine all the people who could potentially have benefited from the knowledge gained by this trial had it accrued as originally intended," Dr. Tong wrote. "With continued enthusiasm and surgeon commitment to multicenter clinical trials, we will be able to elucidate further the role of therapies such as this in preventing complications after lung resection."

The study, expert review and editorial were published online June 22 in the Journal of Thoracic and Cardiovascular Surgery.

The National Institutes of Health funded the research by Dr. Amar and colleagues. Dr. Amar received consulting fees from ETView. Study author Dr. Park received lecture fees from Intuitive Surgical.

Review Date: 
June 24, 2015