the effect of high-dose statin on cardiac biomarkers following lower limb vascular surgery: a randomized clinical trial

Background: patients undergoing peripheral vascular surgery frequently present with comorbid cardiovascular disease, where perioperative myocardial ischemia and infarction represent leading causes of morbidity and mortality. through its plaque-stabilizing properties, atorvastatin may reduce postoperative cardiac complications. objectives: this study investigated whether preoperative high-dose atorvastatin therapy provides cardioprotective benefits for patients requiring lower limb vascular revascularization. methods: we conducted a single-center, double-blind, randomized controlled trial at golestan hospital (ahvaz, iran) between april 2019 and march 2021. eighty eligible patients were randomly assigned (1:1) via computer-generated allocation concealed in opaque envelopes to receive either high-dose atorvastatin (n = 40) or a conventional dose (control, n = 40). the study maintained triple blinding (participants, surgeons, and assessors). serial measurements of cardiac biomarkers [troponin i, creatine kinase-mb (ck-mb), creatine phosphokinase (cpk)], renal function (creatinine), and ecg monitoring were performed at 6, 24, and 72 hours postoperatively. results: baseline characteristics showed no significant intergroup differences. the atorvastatin group demonstrated significantly lower postoperative levels of troponin i (p < 0.05), ck-mb (p < 0.05), and creatinine (p < 0.05). a transient elevation in cpk levels occurred at 6 hours post-surgery in the treatment group (p < 0.05), which subsequently normalized. these findings support the potential myocardial and renal protective effects of high-dose statin therapy in vascular surgery patients. conclusions: perioperative administration of high-dose atorvastatin significantly reduces biochemical markers of cardiac and renal injury following lower extremity vascular procedures. these results suggest statins may improve outcomes in this high-risk surgical population.