SynthesisCritical care (London, England)2016
Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials.
Synthesis in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Perioperative statin administration with decreased risk of postoperative atrial fibrillation, but not acute kidney injury or myocardial infarction: A meta-analysis.Scientific reports · 2017Pooled it
- Pooled it
- Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2016Pooled it
- Divergent Role of Statin Use and Intensity in Patients Undergoing Transcatheter Aortic Valve Replacement.Cardiorenal medicine · 2026Article
- C-reactive protein in cardiovascular disease: clinical associations, conformation-dependent biology, and therapeutic perspectives.Frontiers in immunology · 2026Review
- The Effect of Statins on Bleeding in Isolated Coronary Artery Bypass Grafting Statins in CABG.Journal of clinical medicine · 2025Article
- Impact of Perioperative High-Intensity Statin Use on New-Onset Atrial Fibrillation After Aortic Valve Replacement.Annals of thoracic surgery short reports · 2025Article
- Preexisting statin therapy is not associated with reduced acute kidney injury following cardiac surgery: a retrospective analysis.Frontiers in pharmacology · 2025Review
- Statins and Pacing-Induced Atrial Myopathy: Unraveling Their Role in Atrioventricular Block Patients with Permanent Pacemakers.International journal of medical sciences · 2025Article
- The impact of early use of statin in sepsis patients with acute kidney injury: a study based on MIMIC-IV.Frontiers in pharmacology · 2025Article
- Review
- Intraoperative Remifentanil Use Reduces Atrial Fibrillation After Coronary Artery Bypass Surgery.Journal of the Saudi Heart Association · 2024Article
- Effects of statins on the incidence and outcomes of acute kidney injury in critically ill patients: a systematic review and meta-analysis.Archives of medical science : AMS · 2023Review
- Long-Term Preoperative Atorvastatin or Rosuvastatin Use in Adult Patients before CABG Does Not Increase Incidence of Postoperative Acute Kidney Injury: A Propensity Score-Matched Analysis.Pathophysiology : the official journal of the International Society for Pathophysiology · 2022Article
- Inflammation and Oxidative Stress in the Context of Extracorporeal Cardiac and Pulmonary Support.Frontiers in immunology · 2022Review
- Contemporary Neuroprotection Strategies during Cardiac Surgery: State of the Art Review.International journal of environmental research and public health · 2021Review
- Statins for Patients Undergoing Thoracic Aortic Aneurysm Repair Surgery: What to Do?Aorta (Stamford, Conn.) · 2021Article
- Statin Therapy in Post-Operative Atrial Fibrillation: Focus on the Anti-Inflammatory Effects.Journal of cardiovascular development and disease · 2021Review
- Long-Term Outcomes and Risk Factors of Renal Failure Requiring Dialysis after Heart Transplantation: A Nationwide Cohort Study.Journal of clinical medicine · 2020Article
- Prevention of Cardiac Surgery-Associated Acute Kidney Injury: A Review of Current Strategies.Anesthesiology clinics · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundSeveral studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients.
methodsElectronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery. Postoperative outcomes were acute kidney injury, atrial fibrillation, myocardial infarction, stroke, infections, and mortality. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using fixed-effects meta-analyses. Primary analysis was restricted to trials with low risk of bias according to Cochrane methodology, and sensitivity analyses examined whether the risk of bias of included studies was associated with different results. We performed trial sequential analysis (TSA) to test the strength of the results.
resultsWe included data from 23 RCTs involving 5102 patients. Meta-analysis of trials with low risk of bias showed that statin therapy was associated with an increase in acute kidney injury (314 of 1318 (23.82%) with statins versus 262 of 1319 (19.86%) with placebo; OR 1.26 (95%CI 1.05 to 1.52); p = 0.01); these results were supported by TSA. No difference in postoperative atrial fibrillation, myocardial infarction, stroke, infections, or mortality was present. On sensitivity analysis, statin therapy was associated with a slight increase in hospital mortality. Meta-analysis including also trials with high or unclear risk of bias showed no beneficial effects of statin therapy on any postoperative outcomes.
conclusionsThere is no evidence that statin therapy in the days prior to cardiac surgery is beneficial for patients' outcomes. Particularly, statins are not protective against postoperative atrial fibrillation, myocardial infarction, stroke, or infections. Statins are associated with a possible increased risk of acute kidney injury and a detrimental effect on hospital survival could not be excluded. Future RCTs should further evaluate the safety profile of this therapy in relation to patients' outcomes and assess the more appropriate time point for discontinuation of statins before cardiac surgery.
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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 OpenQuestion graph.