← Statins × cardiovascular events

TrialEuropean heart journal2016

Association between pre-operative statin use and major cardiovascular complications among patients undergoing non-cardiac surgery: the VISION study.

Otavio Berwanger et al.PubMed ↗Full text ↗Publisher ↗

  • Pre-operative statin therapylooks good hereLower composite of all-cause mortality, myocardial injury after non-cardiac surgery , or stroke at 30 days, fewer deaths, fewer cardiovascular deaths.Correlation only, not a test of it.

What moved togetherboth groups pooled, not the treatment’s effect

Correlation, not cause

Pre-operative statin therapy went with lower composite of all-cause mortality, myocardial injury after non-cardiac surgery , or stroke at 30 days

−17%−27% to −5%

pre-operative statin therapy vs no pre-operative statin therapy (controls)

Bigger than 5 in 10 for all-cause mortality

As reported

RR 0.83, 95% CI 0.73–0.95

Correlation, not cause

Pre-operative statin therapy went with fewer deaths

−42%−60% to −17%

pre-operative statin therapy vs no pre-operative statin therapy (controls)

Bigger than 9 in 10 for all-cause mortality

As reported

RR 0.58, 95% CI 0.40–0.83 · the paper's word: all-cause mortality

Correlation, not cause

Pre-operative statin therapy went with fewer cardiovascular deaths

−58%−77% to −24%

pre-operative statin therapy vs no pre-operative statin therapy (controls)

Bigger than 9 in 10 for cardiovascular events

As reported

RR 0.42, 95% CI 0.23–0.76 · the paper's word: cardiovascular mortality

+1 more in the walkthrough ↓

Who was studied, and how

40,060people in the Vascular Events In Noncardiac Surgery Patients Cohort Evaluation trial, from 2007
2,845of them with cardiovascular disease, in this paper

Already taking pre-operative statin therapy, or nottheir own situation, not assigned

on pre-operative statin therapy
not on pre-operative statin therapy (controls)

Pre-operative statin therapy went with lower composite of all-cause mortality, myocardial injury after non-cardiac surgery , or stroke at 30 days−17%

Pre-operative statin therapy went with fewer deaths−42%

Pre-operative statin therapy went with fewer cardiovascular deaths−58%

correlation, not a test

the abstract, start to end

… stroke at 30 days [relative risk (RR), 0.83; 95% confidence interval (CI), …

… lower risk of all-cause mortality (RR, 0.58; 95% CI, 0.40-0.83; P = 0.003), cardiovascular mortality (RR, 0.42; 95% CI, 0.23-0.76; P = 0.004), and MINS (RR, 0.86; 95% CI, 0.73-0.98; P = 0.02).

← favours treatmentfavours comparator →
could be chance
Composite of all-cause mortality, myocardial injury after non-cardiac surgery (MINS), or stroke at 30 dayspre-operative statin therapy vs no pre-operative statin therapy (controls)
RR 0.830.73–0.95
All-cause mortalitypre-operative statin therapy vs no pre-operative statin therapy (controls)
RR 0.580.40–0.83
Cardiovascular mortalitypre-operative statin therapy vs no pre-operative statin therapy (controls)
RR 0.420.23–0.76
MINSpre-operative statin therapy vs no pre-operative statin therapy (controls)
RR 0.860.73–0.98
StatinsCardiovascular eventsAll-cause mortality
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39 papers cite it

2016
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this paperpooled itcites it

2 trials

NCT0051210940,060 enrolled2007NCT04053894220 enrolled2019
Full record →Abstract, authors, funding and every citing paper · PMID 26330424