Evidence map›Paper›PMID 26494361›Full record

ArticlePharmacoepidemiology and drug safety2016

Initiation patterns of statin therapy among adult patients undergoing intermediate to high-risk non-cardiac surgery.

Elisabetta Patorno, Shirley V Wang, Sebastian Schneeweiss, Jun Liu, Brian T Bateman

Open access · greenAbstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 42% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. 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 at 1 institution in 1 country.

Elisabetta PatornoDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Shirley V WangDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Sebastian SchneeweissDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jun LiuDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Brian T BatemanDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Harvard University · US

Funding

Methods for studying treatment heterogeneity using large observational databasesR00HS022193 · AHRQ · BRIGHAM AND WOMEN'S HOSPITAL · PI WANG, SHIRLEY · 2015 to 2017
$747k
Comparative safety & effectiveness of antihypertensive medications in pregnancyK08HD075831 · NICHD · BRIGHAM AND WOMEN'S HOSPITAL · PI BATEMAN, BRIAN THOMAS · 2013 to 2017
$717k
Methods for studying treatment heterogeneity using large observational databasesK99HS022193 · AHRQ · BRIGHAM AND WOMEN'S HOSPITAL · PI WANG, SHIRLEY · 2013 to 2014
$305k
AHRQ HHS K99 HS022193AHRQ HHS R00 HS022193NICHD NIH HHS K08 HD075831
6 · The paper itself

Abstract

backgroundA growing body of literature has been produced on the potential role of statins in reducing perioperative cardiac events in patients undergoing non-cardiac surgery. However, evidence remains inconsistent, and little is known about the patterns of perioperative statin use in routine care.

objectivesThe objective of this study was to examine patterns of perioperative statin initiation among adults undergoing non-cardiac elective surgery in the USA.

methodsUsing data from a large US healthcare insurer, we identified patients aged ≥18 years who underwent moderate-risk to high-risk non-cardiac elective surgery between 2003 and 2012 and initiated statins within 30 days before surgery. We evaluated temporal trends of statin initiation and patient characteristics. In a matched analysis, we assessed the effect of temporal proximity to surgery on the likelihood of statin initiation.

resultsOf 460,154 patients undergoing surgery, 5628 (12 per 1000 patients) initiated a statin within 30 days before surgery. Statin initiation increased from 8 per 1000 patients in 2003 to 15 in 2012 (p = 0.0022). The increase was more pronounced among patients undergoing vascular surgery (149 initiators per 1000 patients by the end of 2012) and with Revised Cardiac Risk Index (RCRI) score ≥2 (72 per 1000 patients). Proximity to surgery, in particular vascular surgery, was predictive of statin initiation.

conclusionsDespite the lack of robust evidence, perioperative statin initiation progressively increased from 2003 to 2012, particularly among patients undergoing major vascular surgery and with higher RCRI score. These trends were largely attributable to the initiation of statins in anticipation of non-cardiac surgery rather than routine dyslipidemia treatment.

Indexed as

Elective Surgical ProceduresAdolescentAdultAgedCardiovascular DiseasesCohort StudiesDrug Administration ScheduleDrug UtilizationFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLogistic ModelsMaleMiddle AgedPerioperative CareUnited StatesHydroxymethylglutaryl-CoA Reductase Inhibitorsischemic heart diseasenon-cardiac surgerypatterns of drug utilizationpharmacoepidemiologystatins

Identifiers

PMID26494361
PMCPMC4843110
OpenAlexW1812168438

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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 OpenQuestion graph.