Evidence mapPaperPMID 17088313Full record

SynthesisBMJ (Clinical research ed.)2006

Strength of evidence for perioperative use of statins to reduce cardiovascular risk: systematic review of controlled studies.

Anmol S Kapoor, Hussein Kanji, Jeanette Buckingham, P J Devereaux, Finlay A McAlister

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01543555 (Multicenter Randomized Controlled Trial of Loading Dose Statins for the Prevention of Cardiovascular Complications in High-Risk Non-Cardiac Surgery), which is not on this map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01543555 phase3completedstarted 2012, after this paper: background citation

Multicenter Randomized Controlled Trial of Loading Dose Statins for the Prevention of Cardiovascular Complications in High-Risk Non-Cardiac Surgery

Ran2012Enrolled648Registered outcomes10Posted comparisons0ConditionsAortic Aneurism, Myocardial Infarction, Peripheral Vascular DiseaseArmsAtorvastatin, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Preoperative statin therapy for adults undergoing cardiac surgery.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Perioperative statin therapy for improving outcomes during and after noncardiac vascular surgery.The Cochrane database of systematic reviews · 2013 · on this map
    Pooled it
  4. Perioperative use of statins in noncardiac surgery.Vascular health and risk management · 2008
    Pooled it
  5. Trial
  6. Statin use in total joint arthroplasty: a systematic review.Annals of medicine and surgery (2012) · 2024
    Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Short-term vascular risk: time to take notice?Nature reviews. Cardiology · 2010
    Review
  12. Article
  13. Article
  14. Perioperative medicine update.Journal of general internal medicine · 2009
    Article
  15. Article
  16. Delirium after elective surgery among elderly patients taking statins.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2008
    Article
  17. [Minimizing perioperative risk - an interdisciplinary effort].Wiener medizinische Wochenschrift (1946) · 2008
    Review
  18. Beta blockers and statins in non-cardiac surgery.BMJ (Clinical research ed.) · 2007
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anmol S KapoorDivision of General Internal Medicine, University of Alberta, 8440 112 Street, Edmonton, AB, Canada T6G 2R7.
Hussein Kanji
Jeanette Buckingham
P J Devereaux
Finlay A McAlister

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the strength of evidence underlying recommendations for use of statins during the perioperative period to reduce the risk of cardiovascular events.

designSystematic review of studies with concurrent control groups. DATA SOURCES: Four electronic databases, the references of identified studies, international experts on perioperative medicine, and the authors of the primary studies. Review methods Two reviewers independently extracted data from studies that reported acute coronary syndromes or mortality in patients receiving or not receiving statins during the perioperative period.

main outcome measureRandom effects summary odds ratios for death or acute coronary syndrome during the perioperative period.

results18 studies--two randomised trials (n=177), 15 cohort studies (n=799,632), and one case-control study (n=480)--assessed whether statins provide perioperative cardiovascular protection; 12 studies enrolled patients undergoing non-cardiac vascular surgery, four enrolled patients undergoing coronary bypass surgery, and two enrolled patients undergoing various surgical procedures. In the randomised trials the summary odds ratio for death or acute coronary syndrome during the perioperative period with statin use was 0.26 (95% confidence interval 0.07 to 0.99) and the summary odds ratio in the cohort studies was 0.70 (0.57 to 0.87). Although the pooled cohort data provided a statistically significant result, statins were not randomly allocated, results in retrospective studies were larger (odds ratio 0.65, 0.50 to 0.84) than those in the prospective cohorts (0.91, 0.65 to 1.27), and dose, duration, and safety of statin use was not reported.

conclusionThe evidence base for routine administration of statins to reduce perioperative cardiovascular risk is inadequate.

Indexed as

Case-Control StudiesCoronary DiseaseHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntraoperative ComplicationsPreoperative CareRandomized Controlled Trials as TopicRisk FactorsSurvival AnalysisHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID17088313
PMCPMC1676124

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.