Les « statines » en période périopératoire : un traitement « à prendre ou à laisser » ?

LDL-cholesterol synthesis is blocked by statins which decrease the risk of adverse cardiovascular events independently. Statins decrease LDL-cholesterol plasma concentration. Pleiotropic effects include endothelial nitric oxide (NO) synthase activation responsible for coronary artery vasodilation, decrease in platelets activity and fibrinolysis activation. Rhabdomyolysis, the main adverse effect, is rare. It is recommended not to stop chronic treatment by statins before surgery. Treatment by statins is reasonable for patients scheduled for vascular surgery with or without risk factors. Patients scheduled for non-vascular surgery with intermediate to high risk, and with at least one risk factor, may receive statins before surgery. All patients scheduled for coronary artery bypass surgery must receive statins before surgery provided they have no contraindication.