Background: Low cholesterol levels in post-surgical patients and those requiring intensive care have been linked to increased infection-rate and subsequent mortality. The relationship between postoperative low cholesterol levels and outcomes following coronary artery bypass grafting (CABG) remains unexplored.
Methods: The data of 50 consecutive patients undergoing isolated CABG between January 1 and February 31 2004 were prospectively reviewed. Blood samples withdrawn prior to, immediately after the operation, and 3 days postoperatively were assayed for cholesterol levels and comparatively assessed with postoperative clinical outcomes. Patients were subgrouped by cholesterol level, < 90(mean =80.3 ±8.9) (n=25) (group I) or >90 (mean=127.6 ±46.3) (n=25) (group II).
Results: All patients were treated with statins prior to and immediately after surgery. Postoperative cholesterol levels decreased reaching a nadir on third postoperative day (POD) (pre operative:188.3±41, POD 1: 100.7±13.9, POD 3: 87.3±20.9 ).
Both subgroups were comparable with regard to baseline characteristics with the exception of ventricular dysfunction in group I (28% vs. 12%, p=NS). Grafts per patient and other operative data were comparable. Postoperative survival was complete and there was no significant difference in postoperative ventilation time, liver function tests and serum creatinine and albumin levels (p=NS). Surgical wound infection-rate (defined as infection in either sternal, or saphenous vein incisions) was significantly higher in group I (28% vs 4%, p=0.07).
Conclusions: Early post-CABG cholesterol levels may be associated with increased risk of infection. Contemporary indications to resume statin treatment immediately postoperatively should be subsequently reconsidered. The prognostic value of low cholesterol levels should be further corroborated in larger cohorts.
