Trial reportThe New England journal of medicine2009
Fluvastatin and perioperative events in patients undergoing vascular surgery.
Trial report in The New England journal of medicine, 2009. The graph read 1 number from its abstract, feeding 1 cell of the map: it supports the treatment in 1. It is linked to 2 registered trials, which are not on this map. Cited by 73 papers, 10 of them syntheses that pooled it.
What it found
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Death from cardiovascular causes or myocardial infarction occurred in 12 patients (4.8%) in the fluvastatin group and 25 patients (10.1%) in the placebo group (hazard ratio, 0.47; 95% CI, 0.24 to 0.94; P=0.03).
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Statins×cardiovascular events
SupportsOpen on the map →What to test next →30 readable studies in this cell: 18 favour the treatment, 11 find no difference, 1 favour the comparator.
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.
Multicenter Randomized Controlled Trial of Loading Dose Statins for the Prevention of Cardiovascular Complications in High-Risk Non-Cardiac Surgery
Open the trial in the graphStatin Therapy To Limit Cognitive Dysfunction After Cardiac Surgery
Who cites it
73 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Preoperative statin therapy for adults undergoing cardiac surgery.The Cochrane database of systematic reviews · 2024Pooled it
- Guideline
- Guideline
- Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm.The Cochrane database of systematic reviews · 2017Pooled it
- HMG CoA reductase inhibitors (statins) for preventing acute kidney injury after surgical procedures requiring cardiac bypass.The Cochrane database of systematic reviews · 2015Pooled it
- Perioperative statin therapy for improving outcomes during and after noncardiac vascular surgery.The Cochrane database of systematic reviews · 2013 · on this mapPooled it
- European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).International journal of behavioral medicine · 2012Guideline
- [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery. Joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].Der Urologe. Ausg. A · 2011Guideline
- Guideline
- 3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology.Arquivos brasileiros de cardiologiaGuideline
- Trial
- Stenting versus endarterectomy for treatment of carotid-artery stenosis.The New England journal of medicine · 2010Trial
- Trial
- Review
- Dyslipidemia and peripheral arterial disease.Indian heart journal · 2024Review
- Statin therapy after elective abdominal aortic aneurysm repair improves long-term survival.The British journal of surgery · 2024Article
- Incidence of and Risk Factors for Prolonged Intensive Care Unit Stay After Open Heart Surgery Among Elderly Patients.Cureus · 2022Article
- Statins in High Cardiovascular Risk Patients: Do Comorbidities and Characteristics Matter?International journal of molecular sciences · 2022Review
- Observational
- Perioperative Statin Use May Reduce Postoperative Arrhythmia Rates After Total Joint Arthroplasty.The Journal of arthroplasty · 2021Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
backgroundAdverse cardiac events are common after vascular surgery. We hypothesized that perioperative statin therapy would improve postoperative outcomes.
methodsIn this double-blind, placebo-controlled trial, we randomly assigned patients who had not previously been treated with a statin to receive, in addition to a beta-blocker, either 80 mg of extended-release fluvastatin or placebo once daily before undergoing vascular surgery. Lipid, interleukin-6, and C-reactive protein levels were measured at the time of randomization and before surgery. The primary end point was the occurrence of myocardial ischemia, defined as transient electrocardiographic abnormalities, release of troponin T, or both, within 30 days after surgery. The secondary end point was the composite of death from cardiovascular causes and myocardial infarction.
resultsA total of 250 patients were assigned to fluvastatin, and 247 to placebo, a median of 37 days before vascular surgery. Levels of total cholesterol, low-density lipoprotein cholesterol, interleukin-6, and C-reactive protein were significantly decreased in the fluvastatin group but were unchanged in the placebo group. Postoperative myocardial ischemia occurred in 27 patients (10.8%) in the fluvastatin group and in 47 (19.0%) in the placebo group (hazard ratio, 0.55; 95% confidence interval [CI], 0.34 to 0.88; P=0.01). Death from cardiovascular causes or myocardial infarction occurred in 12 patients (4.8%) in the fluvastatin group and 25 patients (10.1%) in the placebo group (hazard ratio, 0.47; 95% CI, 0.24 to 0.94; P=0.03). Fluvastatin therapy was not associated with a significant increase in the rate of adverse events.
conclusionsIn patients undergoing vascular surgery, perioperative fluvastatin therapy was associated with an improvement in postoperative cardiac outcome. (Current Controlled Trials number, ISRCTN83738615.)
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Identifiers
19726772What Socratic holds
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.