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. 2024 Jul 22;7(7):CD008493.
doi: 10.1002/14651858.CD008493.pub5.

Preoperative statin therapy for adults undergoing cardiac surgery

Miguel Marques Antunes  1   2 , Afonso Nunes-Ferreira  3 , Gonçalo S Duarte  4   5 , Ryan Gouveia E Melo  1   6 , Bárbara Sucena Rodrigues  7 , Nuno C Guerra  8 , Angelo Nobre  8 , Fausto J Pinto  3 , João Costa  4 , Daniel Caldeira  3   9
Affiliations

Preoperative statin therapy for adults undergoing cardiac surgery

Miguel Marques Antunes et al. Cochrane Database Syst Rev. .

Abstract

Background: Despite significant advances in surgical techniques and perioperative care, people undertaking cardiac surgery due to cardiovascular disease are more prone to the development of postoperative adverse events. Statins (5-hydroxy-3-methylglutaryl-co-enzyme A (HMG-CoA) reductase inhibitors) are well-known for their anti-inflammatory and antioxidant effects and are established for primary and secondary prevention of coronary artery disease. In addition, statins are thought to have clinical benefits in perioperative outcomes in people undergoing cardiac surgery. This review is an update of a review that was first published in 2012 and updated in 2015.

Objectives: To evaluate the benefits and harms of preoperative statin therapy in adults undergoing cardiac surgery compared to standard of care or placebo.

Search methods: We performed a search of the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 9, 2023), Ovid MEDLINE (1980 to 14 September 2023), and Ovid Embase (1980 to 2023 (week 36)). We applied no language restrictions.

Selection criteria: We included all randomised controlled trials (RCTs) comparing any statin treatment before cardiac surgery, for any given duration and dose, versus no preoperative statin therapy (standard of care) or placebo. We excluded trials without a registered trial protocol and trials without approval by an institutional ethics committee.

Data collection and analysis: We used standard Cochrane methodology. Primary outcomes were short-term mortality and major adverse cardiovascular events. Secondary outcomes were myocardial infarction, atrial fibrillation, stroke, renal failure, length of intensive care unit (ICU) stay, length of hospital stay and adverse effects related to statin therapy. We reported effect measures as risk ratios (RRs) or mean differences (MDs) with corresponding 95% confidence intervals (CIs). We used the RoB 1 tool to assess the risk of bias in included trials, and GRADE to assess the certainty of the evidence.

Main results: We identified eight RCTs (five new to this review) including 5592 participants. Pooled analysis showed that statin treatment before surgery may result in little to no difference in the risk of postoperative short-term mortality (RR 1.36, 95% CI 0.72 to 2.59; I2 = 0%; 6 RCTs, 5260 participants; low-certainty evidence; note 2 RCTs reported 0 events in both groups so RR calculated from 4 RCTs with 5143 participants). We are very uncertain about the effect of statins on major adverse cardiovascular events (RR 0.93, 95% CI 0.77 to 1.13; 1 RCT, 2406 participants; very low-certainty evidence). Statins probably result in little to no difference in myocardial infarction (RR 0.88, 95% CI 0.73 to 1.06; I2 = 0%; 5 RCTs, 4645 participants; moderate-certainty evidence), may result in little to no difference in atrial fibrillation (RR 0.87, 95% CI 0.72 to 1.05; I2 = 60%; 8 RCTs, 5592 participants; low-certainty evidence), and may result in little to no difference in stroke (RR 1.47, 95% CI 0.90 to 2.40; I2 = 0%; 4 RCTs, 5143 participants; low-certainty evidence). We are very uncertain about the effect of statins on renal failure (RR 1.04, 95% CI 0.80 to 1.34; I2 = 57%; 4 RCTs, 4728 participants; very low-certainty evidence). Additionally, statins probably result in little to no difference in length of ICU stay (MD 1.40 hours, 95% CI -1.62 to 4.41; I2 = 43%; 3 RCTs, 4528 participants; moderate-certainty evidence) and overall hospital stay (MD -0.31 days, 95% CI -0.64 to 0.03; I2 = 84%; 5 RCTs, 4788 participants; moderate-certainty evidence). No study had any individual risk of bias domain classified as high. However, two studies were at high risk of bias overall given the classification of unclear risk of bias in three domains.

Authors' conclusions: In this updated Cochrane review, we found no evidence that statin use in the perioperative period of elective cardiac surgery was associated with any clinical benefit or worsening, when compared with placebo or standard of care. Compared with placebo or standard of care, statin use probably results in little to no difference in MIs, length of ICU stay and overall hospital stay; and may make little to no difference to mortality, atrial fibrillation and stroke. We are very uncertain about the effects of statins on major harmful cardiac events and renal failure. The certainty of the evidence validating this finding varied from moderate to very low, depending on the outcome. Future trials should focus on assessing the impact of statin therapy on mortality and major adverse cardiovascular events.

Trial registration: ClinicalTrials.gov NCT01653223.

PubMed Disclaimer

Conflict of interest statement

MMA: none.

ANF: none.

GSD: none.

RGM: none.

BR: none.

NG: none.

AN: none.

JC: none.

FP: Vifor Pharma (Independent Contractor – Other), Zogenix Inc. (Independent Contractor – Other), Philips (Independent Contractor – Other), Novartis (Independent Contractor – Other), Bayer (Independent Contractor – Other), Servier Affaires Medicales (Independent Contractor – Other), Daiichi Sankyo Company (Independent Contractor – Other), Boehringer Ingelheim (Independent Contractor – Other)

DC: previous member of the editorial board of Cochrane Heart. DC was not a part of the editorial process of this review. At the time of article submission and revision, DC was no longer a member of the editorial board.

Figures

1
1
Study flow diagram
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 1: Short‐term mortality
1.2
1.2. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 2: Major adverse cardiac events
1.3
1.3. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 3: Myocardial infarction
1.4
1.4. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 4: Atrial fibrillation
1.5
1.5. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 5: Stroke
1.6
1.6. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 6: Renal failure
1.7
1.7. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 7: Length of stay in the intensive care unit (hours)
1.8
1.8. Analysis
Comparison 1: Statins compared to placebo for adults undergoing cardiac surgery, Outcome 8: Length of stay in the hospital (days)
2.1
2.1. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 1: Mortality
2.2
2.2. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 2: Myocardial infarction
2.3
2.3. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 3: Atrial fibrillation
2.4
2.4. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 4: Stroke
2.5
2.5. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 5: Renal failure
2.6
2.6. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 6: Length of stay in the intensive care unit (hours)
2.7
2.7. Analysis
Comparison 2: Statins compared to placebo for adults undergoing cardiac surgery (statins discontinuation ≤ 21 days before the surgery versus statins discontinuation > 21 days before surgery), Outcome 7: Length of stay in the hospital (days)
3.1
3.1. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 1: Mortality
3.2
3.2. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 2: Myocardial infarction
3.3
3.3. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 3: Atrial fibrillation
3.4
3.4. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 4: Stroke
3.5
3.5. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 5: Renal failure
3.6
3.6. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 6: Length of stay in the intensive care unit (hours)
3.7
3.7. Analysis
Comparison 3: Statins compared to placebo for adults undergoing cardiac surgery (coronary artery bypass graft (CABG) versus non‐CABG), Outcome 7: Length of stay in the hospital (days)
4.1
4.1. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 1: Mortality
4.2
4.2. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 2: Myocardial infarction
4.3
4.3. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 3: Atrial fibrillation
4.4
4.4. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 4: Stroke
4.5
4.5. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 5: Renal failure
4.6
4.6. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 6: Length of stay in the intensive care unit (hours)
4.7
4.7. Analysis
Comparison 4: Statins compared to placebo for adults undergoing cardiac surgery (sensitivity analysis excluding studies with at least one domain unclear in the risk of bias assessment), Outcome 7: Length of stay in the hospital (days)
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Almansob 2012 {published data only}
    1. Almansob MA, Xu B, Zhou L, Hu XX, Chen W, Chang FJ, et al. Simvastatin reduces myocardial injury undergoing noncoronary artery cardiac surgery: a randomized controlled trial. Arteriosclerosis, Thrombosis, and Vascular Biology 2012;32(9):2304-13. [PMID: ] - PubMed
    1. NCT01178710. Effect of simvastatin on cardiac function. clinicaltrials.gov/study/NCT01178710 (first received 9 August 2010).
Baran 2012 {published data only}
    1. Baran C, Durdu S, Dalva K, Zaim C, Dogan A, Ocakoglu G, et al. Effects of preoperative short term use of atorvastatin on endothelial progenitor cells after coronary surgery: a randomized, controlled trial. Stem Cell Reviews 2012;8(3):963-71. [PMID: ] - PubMed
Billings 2016 {published data only}
    1. Billings FT 4th, Hendricks PA, Schildcrout JS, Shi Y, Petracek MR, Byrne JG, et al. High-dose perioperative atorvastatin and acute kidney injury following cardiac surgery: a randomized clinical trial. JAMA 2016;315(9):877-88. [PMID: ] - PMC - PubMed
Liakopoulos 2023 {published data only}
    1. Liakopoulos OJ, Kuhn EW, Hellmich M, Schlömicher M, Strauch J, Reents W, et al, StaRT-CABG Investigators. Statin loading before coronary artery bypass grafting: a randomized trial. European Heart Journal 2023;44(25):2322-31. [DOI: 10.1093/eurheartj/ehad238] [PMID: ] - DOI - PubMed
Mannacio 2008 {published data only}
    1. Mannacio VA, Iorio D, De Amicis V, Di Lello F, Musumeci F. Effect of rosuvastatin pretreatment on myocardial damage after coronary surgery: a randomized trial. Journal of Thoracic and Cardiovascular Surgery 2008;136(6):1541-8. [PMID: ] - PubMed
Park 2016 {published data only}
    1. Park JH, Shim JK, Song JW, Soh S, Kwak YL. Effect of atorvastatin on the incidence of acute kidney injury following valvular heart surgery: a randomized, placebo-controlled trial. Intensive Care Medicine 2016;42(9):1398-407. [PMID: ] - PubMed
Vukovic 2011 {published data only}
    1. Vukovic PM, Maravic-Stojkovic VR, Peric MS, Jovic MD, Cirkovic MV, Gradinac SD, et al. Steroids and statins: an old and a new anti-inflammatory strategy compared. Perfusion 2011;26(1):31-7. [PMID: ] - PubMed
Zheng 2016 {published data only}
    1. Zheng Z, Jayaram R, Jiang L, Emberson J, Zhao Y, Li Q, et al. Perioperative rosuvastatin in cardiac surgery. New England Journal of Medicine 2016;374(18):1744-53. [PMID: ] - PubMed

References to studies excluded from this review

Ali 2005 {published data only}
    1. Ali IS, Buth KJ. Preoperative statin use and in-hospital outcomes following heart surgery in patients with unstable angina. European Journal of Cardio-thoracic Surgery 2005;27(6):1051-6. [PMID: ] - PubMed
Allah 2019 {published data only}
    1. Allah EA, Kamel EZ, Osman HM, Abd-Elshafy SK, Nabil F, Elmelegy TT, et al. Could short-term perioperative high-dose atorvastatin offer antiarrhythmic and cardio-protective effects in rheumatic valve replacement surgery? Journal of Cardiothoracic and Vascular Anesthesia 2019;33(12):3340-7. [PMID: ] - PubMed
Ambrosi 2013 {published data only}
    1. Ambrosi P. Short-term clinical effects of periprocedural statin therapy [Effets cliniques a court terme des statines initiees avant une intervention]. Presse Medicale 2013;42(3):261-8. [PMID: ] - PubMed
Antoniades 2010a {published data only}
    1. Antoniades C, Bakagiannis C, Tousoulis D, Zhang M-H, Demosthenous M, Antonopoulos A, et al. Preoperative atorvastatin treatment rapidly improves vein graft redox state by inhibiting rac1 and NADPH oxidase activity in patients undergoing elective CABG. European Heart Journal 2010;31:310. - PubMed
Antoniades 2010b {published data only}
    1. Antoniades C, Bakogiannis C, Tousoulis D, Reilly S, Zhang MH, Paschalis A, et al. Preoperative atorvastatin treatment in CABG patients rapidly improves vein graft redox state by inhibition of Rac1 and NADPH-oxidase activity. Circulation 2010;122(11 Suppl):S66-73. [PMID: ] - PubMed
Antoniades 2011 {published data only}
    1. Antoniades C, Bakogiannis C, Leeson P, Guzik TJ, Zhang MH, Tousoulis D, et al. Rapid, direct effects of statin treatment on arterial redox state and nitric oxide bioavailability in human atherosclerosis via tetrahydrobiopterin-mediated endothelial nitric oxide synthase coupling. Circulation 2011;124(3):335-45. [PMID: ] - PMC - PubMed
    1. Antoniades C, Bakogiannis C, Tousoulis D, Antonopoulos AS, Lee R, Demosthenous M, et al. Oral atorvastatin treatment improves NO bioavailability and vascular redox state in the human arterial wall, via a tetrahydrobiopterin-mediated improvement of eNOS coupling. Circulation 2011;1:1. [Accession Number 70618705]
    1. Antoniades C, Bakogiannis C, Tousoulis D, Antonopoulos AS, Lee R, Demosthenous M, et al. Statin treatment improves vascular redox state through a tetrahydrobiopterin-mediated re-coupling of endothelial nitric oxide synthase, in human atherosclerosis. European Heart Journal 2011;32:989. [Accession Number 70536767]
    1. Antoniades C, Bakogiannis C, Tousoulis D, Zhang MH, Demosthenous M, Antonopoulos A, et al. Preoperative atorvastatin treatment rapidly improves vein graft redox state by inhibiting rac1 and NADPH oxidase activity in patients undergoing elective CABG. European Heart Journal 2010;31:310. [DOI: 10.1093/eurheartj/ehq288] [Accession Number 70280690] - DOI - PubMed
    1. Antoniades C, Demosthenous M, Margaritis M, Tousoulis D, Antonopoulos A, Paschalis A, et al. Short-term preoperative treatment with atorvastatin improves myocardial redox state in patients undergoing elective CABG by affecting NADPH oxidase activity and NOS coupling. European Heart Journal 2010;31:60. [DOI: 10.1093/eurheartj/ehq287] [Accession Number 70279719] - DOI
Antoniades 2012a {published data only}
    1. Antoniades C, Demosthenous M, Reilly S, Margaritis M, Zhang MH, Antonopoulos A, et al. Myocardial redox state predicts in-hospital clinical outcome after cardiac surgery effects of short-term pre-operative statin treatment. Journal of the American College of Cardiology 2012;59(1):60-70. [PMID: ] - PubMed
Baigent 2011 {published data only}
    1. Baigent C, Landray MJ, Reith C. Simvastatin plus ezetimibe reduced major atherosclerotic events in patients with chronic kidney disease. Annals of Internal Medicine 2011;155:JC5-2. [Accession Number 2011626751] - PubMed
Barbir 1994 {published data only}
    1. Barbir M, Hunt BJ, Galloway D, Taylor A, Ilsley C, Mitchell A, et al. A randomized pilot trial of low-dose combination lipid-lowering therapy following coronary artery bypass grafting. Clinical Cardiology 1994;17(2):59-64. [PMID: ] - PubMed
Berkan 2009 {published data only}
    1. Berkan O, Katrancioglu N, Ozker E, Ozerdem G, Bakici Z, Yilmaz MB. Reduced P-selectin in hearts pretreated with fluvastatin: a novel benefit for patients undergoing open heart surgery. Thoracic and Cardiovascular Surgeon 2009;57(2):91-5. [PMID: ] - PubMed
Borger 2010 {published data only}
    1. Borger MA, Seeburger J, Walther T, Borger F, Rastan A, Doenst T, et al. Effect of preoperative statin therapy on patients undergoing isolated and combined valvular heart surgery. Annals of Thoracic Surgery 2010;89(3):773-9; discussion 779-80. [PMID: ] - PubMed
Brophy 2005 {published data only}
    1. Brophy JM, Brassard P, Bourgault C. The benefit of cholesterol-lowering medications after coronary revascularization: a population study. American Heart Journal 2005;150(2):282-6. [PMID: ] - PubMed
Brull 2001 {published data only}
    1. Brull DJ, Sanders J, Rumley A, Lowe GD, Humphries SE, Montgomery HE. Statin therapy and the acute inflammatory response after coronary artery bypass grafting. American Journal of Cardiology 2001;88(4):431-3. [PMID: ] - PubMed
Candura 2008 {published data only}
    1. Candura C, Chello M, Lusini M, Patti G, Barbato R, Sciascio G. A randomised trial of atorvastatin for reduction of myocardial damage during CABG: the ARMYDA-4 study (atorvastatin for reduction of myocardial damage). Interactive CardioVascular and Thoracic Surgery 2008;7:674-8. [Accession Number CN-00865939]
Cannon 2004 {published data only}
    1. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. New England Journal of Medicine 2004;350(15):1495-504. [PMID: ] - PubMed
Caorsi 2008 {published data only}
    1. Caorsi C, Pineda F, Munoz C. Pravastatin immunomodulates IL-6 and C-reactive protein, but not IL-1 and TNF-alpha, in cardio-pulmonary bypass. European Cytokine Network 2008;19(2):99-103. [PMID: ] - PubMed
Carrascal 2016 {published data only}
    1. Carrascal Y, Arnold RJ, la Fuente L, Revilla A, Sevilla T, Arce N, et al. Efficacy of atorvastatin in prevention of atrial fibrillation after heart valve surgery in the PROFACE trial (PROphylaxis of postoperative atrial Fibrillation After Cardiac surgEry). Journal of Arrhythmia 2016;32(3):191-7. [PMID: ] - PMC - PubMed
Castaño 2015 {published data only}
    1. Castaño M, González-Santos JM, López J, García B, Centeno JE, Aparicio B, et al. Effect of preoperative oral pravastatin reload in systemic inflammatory response and myocardial damage after coronary artery bypass grafting. A pilot double-blind placebo-controlled study. Journal of Cardiovascular Surgery (Torino) 2015;56(4):617-29. [PMID: ] - PubMed
Chello 2003 {published data only}
    1. Chello M, Mastroroberto P, Patti G, D'Ambrosio A, Morichetti MC, Di Sciascio G, et al. Simvastatin attenuates leucocyte-endothelial interactions after coronary revascularisation with cardiopulmonary bypass. Heart (British Cardiac Society) 2003;89(5):538-43. [PMID: ] - PMC - PubMed
Chello 2004 {published data only}
    1. Chello M, Carassiti M, Agro F, Mastroroberto P, Pugliese G, Colonna D, et al. Simvastatin blunts the increase of circulating adhesion molecules after coronary artery bypass surgery with cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia 2004;18(5):605-9. [PMID: ] - PubMed
Chello 2005 {published data only}
    1. Chello M, Goffredo C, Patti G, Candura D, Melfi R, Mastrobuoni S, et al. Effects of atorvastatin on arterial endothelial function in coronary bypass surgery. European Journal of Cardio-thoracic Surgery 2005;28(6):805-10. [PMID: ] - PubMed
Chello 2006 {published data only}
    1. Chello M, Patti G, Candura D, Mastrobuoni S, Di Sciascio G, Agro F, et al. Effects of atorvastatin on systemic inflammatory response after coronary bypass surgery. Critical Care Medicine 2006;34(3):660-7. [PMID: ] - PubMed
Chello 2007 {published data only}
    1. Chello M, Anselmi A, Spadaccio C, Patti G, Goffredo C, Di Sciascio G, et al. Simvastatin increases neutrophil apoptosis and reduces inflammatory reaction after coronary surgery. Annals of Thoracic Surgery 2007;83(4):1374-80. [PMID: ] - PubMed
Cherkanova 2009 {published data only}
    1. Cherkanova MS, Korolenko TA, Bravve II, Gerasimova TP. The activity of metalloproteinases and concentration of C-reactive protein in the blood of patients with coronary heart disease during the administration of statins and coronary artery bypass surgery. Klinicheskaia Laboratornaia Diagnostika 2009;6:9-11. [PMID: ] - PubMed
Cherkanova 2012 {published data only}
    1. Cherkanova MS, Korolenko TA, Bravve II, Gerasimova TP. Effect of statins on activity of matrix metalloproteases and serum concentration of cystatin C in patients with various risk of development of ischemic heart disease and in patients after coronary artery bypass surgery. Kardiologiia 2012;52(2):23-8. [PMID: ] - PubMed
Christenson 1999 {published data only}
    1. Christenson JT. Preoperative lipid control with simvastatin protects coronary artery bypass from obstructive graft disease. American Journal of Cardiology 2001;88(8):896-9. [PMID: ] - PubMed
    1. Christenson JT. Preoperative lipid-control with simvastatin reduces the risk of postoperative thrombocytosis and thrombotic complications following CABG. European Journal of Cardio-thoracic Surgery 1999;15(4):394-9; discussion 399-400. [PMID: ] - PubMed
Christenson 2001 {published data only}
    1. Christenson JT. Preoperative lipid control with simvastatin reduces the risk for graft failure already 1 year after myocardial revascularization. Cardiovascular Surgery (London, England) 2001;9(1):33-43. [PMID: ] - PubMed
Coccia 2007 {published data only}
    1. Coccia R, Spadaccio C, Foppoli C, Perluigi M, Covino E, Lusini M, et al. The effect of simvastatin on erythrocyte membrane fluidity during oxidative stress induced by cardiopulmonary bypass: a randomized controlled study. Clinical Therapeutics 2007;29(8):1706-17. [PMID: ] - PubMed
Collard 2006 {published data only}
    1. Collard CD, Body SC, Shernan SK, Wang S, Mangano DT. Preoperative statin therapy is associated with reduced cardiac mortality after coronary artery bypass graft surgery. Journal of Thoracic and Cardiovascular Surgery 2006;132(2):392-400. [PMID: ] - PubMed
Dehghani 2015 {published data only}
    1. Dehghani MR, Kasianzadeh M, Rezaei Y, Sepehrvand N. Atorvastatin reduces the incidence of postoperative atrial fibrillation in statin-naive patients undergoing isolated heart valve surgery: a double-blind, placebo-controlled randomized trial. Journal of Cardiovascular Pharmacology and Therapeutics 2015;20(5):465-72. [PMID: ] - PubMed
Dereli 2008 {published data only}
    1. Dereli Y, Ege E, Kurban S, Narin C, Sarigul A, Yeniterzi M. Pre-operative atorvastatin therapy to decrease the systemic inflammatory response after coronary artery bypass grafting. Journal of International Medical Research 2008;36(6):1248-54. [PMID: ] - PubMed
Dotani 2000 {published data only}
    1. Dotani MI, Elnicki DM, Jain AC, Gibson CM. Effect of preoperative statin therapy and cardiac outcomes after coronary artery bypass grafting. American Journal of Cardiology 2000;86(10):1128-30, A6. [PMID: ] - PubMed
Dotani 2003 {published data only}
    1. Dotani MI, Morise AP, Haque R, Jain AC, Gupta N, Gibson CM. Association between short-term simvastatin therapy before coronary artery bypass grafting and postoperative myocardial blood flow as assessed by positron emission tomography. American Journal of Cardiology 2003;91(9):1107-9. [PMID: ] - PubMed
Fedoruk 2008 {published data only}
    1. Fedoruk LM, Wang H, Conaway MR, Kron IL, Johnston KC. Statin therapy improves outcomes after valvular heart surgery. Annals of Thoracic Surgery 2008;85(5):1521-5; discussion 1525-6. [PMID: ] - PMC - PubMed
Florens 2001 {published data only}
    1. Florens E, Salvi S, Peynet J, Elbim C, Mallat Z, Bel A, et al. Can statins reduce the inflammatory response to cardiopulmonary bypass? A clinical study. Journal of Cardiac Surgery 2001;16(3):232-9. [PMID: ] - PubMed
Hua 2017 {published data only}
    1. Hua P, Liu J, Tao J, Zou R, Lin X, Zhang D, et al. Efficacy and mechanism of preoperative simvastatin therapy on myocardial protection after extracorporeal circulation. BioMed Research International 2017;2017:6082430. [PMID: ] - PMC - PubMed
Huffmyer 2009 {published data only}
    1. Huffmyer JL, Mauermann WJ, Thiele RH, Ma JZ, Nemergut EC. Preoperative statin administration is associated with lower mortality and decreased need for postoperative hemodialysis in patients undergoing coronary artery bypass graft surgery. Journal of Cardiothoracic and Vascular Anesthesia 2009;23(4):468-73. [PMID: ] - PubMed
Ji 2009 {published data only}
    1. Ji Q, Mei Y, Wang X, Sun Y, Feng J, Cai J, et al. Effect of preoperative atorvastatin therapy on atrial fibrillation following off-pump coronary artery bypass grafting. Circulation Journal 2009;73(12):2244-9. [PMID: ] - PubMed
Kabir 2013 {published data only}
    1. Kabir S, Hjortshoj S, Schmidt EB, Arya A, Christensen JH, Lundbye-Christensen S, et al. High dose atorvastatin therapy and QTc interval in patients treated with coronary bypass surgery. International Journal of Cardiology 2013;168(2):1526-8. [PMID: ] - PubMed
Kasai 2009 {published data only}
    1. Kasai T, Miyauchi K, Kajimoto K, Kubota N, Kurata T, Amano A, et al. The impact of pravastatin therapy on long-term outcome in patients with metabolic syndrome undergoing complete coronary revascularization. Circulation Journal 2009;73(11):2104-9. [PMID: ] - PubMed
Kourliouros 2008 {published data only}
    1. Kourliouros A, De Souza A, Roberts N, Marciniak A, Tsiouris A, Valencia O, et al. Dose-related effect of statins on atrial fibrillation after cardiac surgery. Annals of Thoracic Surgery 2008;85(5):1515-20. [PMID: ] - PubMed
Kourliouros 2011 {published data only}
    1. Kourliouros A, Valencia O, Hosseini MT, Mayr M, Sarsam M, Camm J, et al. Preoperative high-dose atorvastatin for prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial. Journal of Thoracic and Cardiovascular Surgery 2011;141(1):244-8. [PMID: ] - PubMed
Krivoy 2008 {published data only}
    1. Krivoy N, Adler Z, Saloma R, Hawadie A, Azzam ZS. Targeting C-reactive protein levels using high-dose atorvastatin before coronary artery bypass graft surgery. Experimental and Clinical Cardiology 2008;13(4):171-4. [PMID: ] - PMC - PubMed
Kulik 2008 {published data only}
    1. Kulik A, Brookhart MA, Levin R, Ruel M, Solomon DH, Choudhry NK. Impact of statin use on outcomes after coronary artery bypass graft surgery. Circulation 2008;118(18):1785-92. [PMID: ] - PubMed
Kumar 2006 {published data only}
    1. Kumar A, Kapoor A, Agarwal SK, Tewari S, Pandey S, Sharma MK, et al. Randomized trial of high vs low-dose atorvastatin for reduction of myocardial damage following coronary artery bypass graft surgery. Indian Heart Journal 2006;58:5.
Kurban 2009 {published data only}
    1. Kurban S, Mehmetoglu I, Ege E. Effect of preoperative atorvastatin therapy on paraoxonase activity and oxidative stress after coronary artery bypass grafting. Perfusion 2009;24(4):271-6. [PMID: ] - PubMed
Lertsburapa 2008 {published data only}
    1. Lertsburapa K, White CM, Kluger J, Faheem O, Hammond J, Coleman CI. Preoperative statins for the prevention of atrial fibrillation after cardiothoracic surgery. Journal of Thoracic and Cardiovascular Surgery 2008;135(2):405-11. [PMID: ] - PubMed
Liakopoulos 2006b {published data only}
    1. Liakopoulos OJ, Dorge H, Schmitto JD, Nagorsnik U, Grabedunkel J, Schoendube FA. Effects of preoperative statin therapy on cytokines after cardiac surgery. Thoracic and Cardiovascular Surgeon 2006;54(4):250-4. [PMID: ] - PubMed
Ludman 2011 {published data only}
    1. Ludman AJ, Hausenloy DJ, Babu G, Hasleton J, Venugopal V, Boston-Griffiths E, et al. Failure to recapture cardioprotection with high-dose atorvastatin in coronary artery bypass surgery: a randomised controlled trial. Basic Research in Cardiology 2011;106(6):1387-95. [PMID: ] - PubMed
    1. Ludman AJ, Hausenloy DJ, Venugopal V, Babu G, Boston-Griffiths E, Lawrence D, et al. The effect of high-dose atorvastatin on a background of standard-dose chronic statin therapy in patients undergoing cardiac surgery. European Heart Journal 2010;31:70. [DOI: 10.1093/eurheartj/ehq287] [Accession Number 70279760] - DOI
Lysgaard 2012 {published data only}
    1. Lysgaard C, Nielsen MS, Christensen JH, Lundbye-Christensen S, Riahi S, Schmidt EB. No effect of high-dose atorvastatin on leukotriene B(4) formation from neutrophils in patients treated with coronary bypass surgery: a randomized placebo-controlled double-blinded trial with a crossover design. Prostaglandins, Leukotrienes, and Essential Fatty Acids 2012;87(6):185-8. [PMID: ] - PubMed
Mansour 2017 {published data only}
    1. Mansour H, Ghaleb R. Atorvastatin for reduction of postoperative atrial fibrillation in patients undergoing cardiac surgery. Atherosclerosis Supplements 2017;25:e1-e11.
Margaritis 2012 {published data only}
    1. Margaritis M, Antoniades C. Statins in coronary artery bypass grafting surgery: lipid lowering and beyond. Expert Review of Cardiovascular Therapy 2012;10(1):5-8. [PMID: ] - PubMed
Martinez‐Comendador 2009 {published data only}
    1. Martinez-Comendador JM, Alvarez JR, Mosquera I, Sierra J, Adrio B, Carro JG, et al. Preoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery. European Journal of Cardio-thoracic Surgery 2009;36(6):998-1005. [PMID: ] - PubMed
Melina 2009 {published data only}
    1. Melina G, Angeloni E, Di Nucci G, Benedetto U, Fiorani B, Sclafani G, et al. Preoperative HMG-CoA reductase inhibitors and atrial fibrillation in patients undergoing CABG: a prospective randomised trial. European Heart Journal 2009;30:32.
Miceli 2009 {published data only}
    1. Miceli A, Fino C, Fiorani B, Yeatman M, Narayan P, Angelini GD, et al. Effects of preoperative statin treatment on the incidence of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. Annals of Thoracic Surgery 2009;87(6):1853-8. [PMID: ] - PubMed
Mukamal 2006 {published data only}
    1. Mukamal KJ, Smith CC, Karlamangla AS, Moore AA. Moderate alcohol consumption and safety of lovastatin and warfarin among men: the post-coronary artery bypass graft trial. American Journal of Medicine 2006;119(5):434-40. [PMID: ] - PubMed
Muraki 2010 {published data only}
    1. Muraki S, Kawaharada N, Higami T. Potential use of statins in reducing atrial fibrillation after off-pump coronary artery bypass grafting surgery. Circulation Journal 2010;74(9):1798-9. [PMID: ] - PubMed
Nakamura 2006 {published data only}
    1. Nakamura K, Masuda H, Kariyazono H, Arima J, Iguro Y, Yamada K, et al. Effects of atorvastatin and aspirin combined therapy on inflammatory responses in patients undergoing coronary artery bypass grafting. Cytokine 2006;36(5-6):201-10. [PMID: ] - PubMed
NCT00811330 {unpublished data only}
    1. NCT00811330. Effects of high dose atorvastatin in patients with surgical aortic stenosis. clinicaltrials.gov/ct2/show/NCT00811330 (first received 17 December 2008).
NCT01573143 {published data only}
    1. NCT01573143. Statin therapy in cardiac surgery (STICS). clinicaltrials.gov/ct2/show/NCT01573143 (first received 13 February 2012).
NCT01780740 {published data only}
    1. NCT01780740. Statin therapy in atrial refractoriness and reperfusion injury (STARR). clinicaltrials.gov/ct2/show/NCT01780740 (first received 23 January 2013).
NCT01909739 {published data only}
    1. NCT01909739. The effects of statin on postoperative renal function in valvular heart surgery: a randomized, placebo-controlled study. clinicaltrials.gov/ct2/show/NCT01909739 (first received 24 July 2013).
On 2008 {published data only}
    1. On YK. Atorvastatin for prevention of postoperative atrial fibrillation after off-pump coronary artery bypass grafting surgery. American Heart Journal 2008;156(2):373.e9-16. [Accession Number CN-00867070] - PubMed
Ouattara 2009 {published data only}
    1. Ouattara A, Benhaoua H, Le Manach Y, Mabrouk-Zerguini N, Itani O, Osman A, et al. Perioperative statin therapy is associated with a significant and dose-dependent reduction of adverse cardiovascular outcomes after coronary artery bypass graft surgery. Journal of Cardiothoracic and Vascular Anesthesia 2009;23(5):633-8. [PMID: ] - PubMed
Ozaydin 2007 {published data only}
    1. Ozaydin M, Dogan A, Varol E, Kapan S, Tuzun N, Peker O, et al. Statin use before by-pass surgery decreases the incidence and shortens the duration of postoperative atrial fibrillation. Cardiology 2007;107(2):117-21. [PMID: ] - PubMed
Pan 2004 {published data only}
    1. Pan W, Pintar T, Anton J, Lee VV, Vaughn WK, Collard CD. Statins are associated with a reduced incidence of perioperative mortality after coronary artery bypass graft surgery. Circulation 2004;110(11 Suppl 1):II45-9. [PMID: ] - PubMed
Papathanasiou 2008 {published data only}
    1. Papathanasiou A, Toumpoulis IK, Milionis HJ, Kalantzi K, Katsouras CS, Goudevenos J. Statin therapy is associated with reduced total and cardiovascular mortality after coronary artery bypass grafting surgery. Coronary Artery Disease 2008;19(8):619-25. [PMID: ] - PubMed
Pascual 2006 {published data only}
    1. Pascual DA, Arribas JM, Tornel PL, Marin F, Oliver C, Ahumada M, et al. Preoperative statin therapy and troponin T predict early complications of coronary artery surgery. Annals of Thoracic Surgery 2006;81(1):78-83. [PMID: ] - PubMed
Patti 2006a {published data only}
    1. Patti G, Chello M, Candura D, Pasceri V, D'ambrosio A, Nusca A, et al. A randomized trial of atorvastatin for reduction of post-operative atrial fibrillation in patients undergoing cardiac surgery. EHJ Supplement 2006;27:827-985. [DOI: 10.1093/eurheartj/ehl215] - DOI - PubMed
Patti 2006b {published data only}
    1. Patti G, Chello M, Candura D, Pasceri V, D'Ambrosio A, Nusca A. A randomized trial of atorvastatin for reduction of post-operative atrial fibrillation in patients undergoing cardiac surgery. Circulation 2006;114(14):1455-61. [DOI: 10.1161/CIRCULATIONAHA.106.621763] - DOI - PubMed
Patti 2010 {published data only}
    1. Patti G, Chello M, Gatto L, Alfano G, Miglionico M, Covino E, et al. Short-term atorvastatin preload reduces levels of adhesion molecules in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Results from the ARMYDA-ACS CAMs (Atorvastatin for Reduction of MYocardial Damage during Angioplasty-Cell Adhesion Molecules) substudy. Journal of Cardiovascular Medicine (Hagerstown, Md) 2010;11(11):795-800. [PMID: ] - PubMed
Patti 2011 {published data only}
    1. Patti G, Ricottini E, Nusca A, Colonna G, Pasceri V, D'Ambrosio A, et al. Short-term, high-dose atorvastatin pretreatment to prevent contrast-induced nephropathy in patients with acute coronary syndromes undergoing percutaneous coronary intervention (from the ARMYDA-CIN [atorvastatin for reduction of myocardial damage during angioplasty–contrast-induced nephropathy] trial). American Journal of Cardiology 2011;108(1):1-7. [PMID: ] - PubMed
Post 2012 {published data only}
    1. Post S, Post MC, den Branden BJ, Eefting FD, Goumans MJ, Stella PR, et al. Early statin treatment prior to primary PCI for acute myocardial infarction: REPERATOR, a randomized placebo-controlled pilot trial. Catheterization and Cardiovascular Interventions 2012;80(5):756-65. [PMID: ] - PubMed
Prowle 2010 {published data only}
    1. Prowle JR, Licari E, Calzavacc P, Ligabo EV, Echeverri JE, Hasse M, et al. Peri-operative statin therapy does not alter the incidence of acute kidney injury after cardiopulmonary bypass: creat, the cardiopulmonary bypass, renal injury and atorvastatin trial. Intensive Care Medicine 2010;36:S88. [DOI: 10.1007/s00134-010-1999-x] [Accession Number 70290230] - DOI
Prowle 2012 {published data only}
    1. Prowle JR, Calzavacca P, Licari E, Ligabo EV, Echeverri JE, Haase M, et al. Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery. Nephrology (Carlton, Vic.) 2012;17(3):215-24. [PMID: ] - PubMed
Radaelli 2007 {published data only}
    1. Radaelli A, Loardi C, Cazzaniga M, Balestri G, DeCarlini C, Cerrito MG, et al. Inflammatory activation during coronary artery surgery and its dose-dependent modulation by statin/ACE-inhibitor combination. Arteriosclerosis, Thrombosis, and Vascular Biology 2007;27(12):2750-5. [PMID: ] - PubMed
Sasmazel 2010 {published data only}
    1. Sasmazel A, Baysal A, Fedekar A, Buyukbayrak F, Bugra O, Erdem H, et al. The effect of statin therapy on stimulation of endothelium-derived nitric oxide before and after coronary artery bypass surgery. Heart Surgery Forum 2010;13(4):E243-6. [PMID: ] - PubMed
Sharma 2005 {published data only}
    1. Sharma MK, Kapoor A, Agarwal SK, Tewari S, Pandey S, Singh SK, et al. Randomized trial of high versus low-dose atorvastatin for reduction of myocardial damage following coronary artery bypass graft surgery. Indian Heart Journal 2005;57(5):Abstract.
Song 2007 {published data only}
    1. Song YB, On YK, Kim JH, Park MJ, Sung KI, Lee YT, et al. Pretreatment with statins protects against atrial fibrillation after coronary artery bypass graft surgery. EP Europace 2007;9(Supp 3):96.
Song 2008 {published data only}
    1. Song YB, On YK, Kim JH, Shin DH, Kim JS, Sung J, et al. The effects of atorvastatin on the occurrence of postoperative atrial fibrillation after off-pump coronary artery bypass grafting surgery. American Heart Journal 2008;156(2):373.e9-16. [PMID: ] - PubMed
Spadaccio 2010 {published data only}
    1. Spadaccio C, Pollari F, Casacalenda A, Alfano G, Genovese J, Covino E, et al. Atorvastatin increases the number of endothelial progenitor cells after cardiac surgery: a randomized control study. Journal of Cardiovascular Pharmacology 2010;55(1):30-8. [PMID: ] - PubMed
Subramaniam 2008 {published data only}
    1. Subramaniam K, Koch CG, Bashour A, O'Connor M, Xu M, Gillinov AM, et al. Preoperative statin intake and morbid events after isolated coronary artery bypass grafting. Journal of Clinical Anesthesia 2008;20(1):4-11. [PMID: ] - PubMed
Sun 2009 {published data only}
    1. Sun YF, Mei YQ, Ji Q, Wang XS, Feng J, Cai JZ, et al. Effect of atorvastatin on postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. Zhonghua Yi Xue Za Zhi 2009;89(42):2988-91. [PMID: ] - PubMed
Sun 2010 {published data only}
    1. Sun Y, Qi G, Gao Y, Zhang H, Pang X, Zhao W, et al. Effect of different loading doses of atorvastatin on percutaneous coronary intervention for acute coronary syndromes. Canadian Journal of Cardiology 2010;26(9):481-5. [PMID: ] - PMC - PubMed
Sun 2011 {published data only}
    1. Sun Y, Ji Q, Mei Y, Wang X, Feng J, Cai J, et al. Role of preoperative atorvastatin administration in protection against postoperative atrial fibrillation following conventional coronary artery bypass grafting. International Heart Journal 2011;52(1):7-11. [PMID: ] - PubMed
Tabata 2007 {published data only}
    1. Tabata M, Khalpey Z, Pirundini PA, Byrne ML, Cohn LH, Rawn JD. Renoprotective effect of preoperative statins in coronary artery bypass grafting. American Journal of Cardiology 2007;100(3):442-4. [PMID: ] - PubMed
Tabata 2008 {published data only}
    1. Tabata M, Khalpey Z, Cohn LH, Chen FY, Bolman RM 3rd, Rawn JD. Effect of preoperative statins in patients without coronary artery disease who undergo cardiac surgery. Journal of Thoracic and Cardiovascular Surgery 2008;136(6):1510-3. [PMID: ] - PubMed
Takagi 2010 {published data only}
    1. Takagi H, Umemoto T. Effect of preoperative statin therapy on postoperative atrial fibrillation in cardiac surgery. Circulation Journal 2010;74(12):2788-9; author reply 2790. [PMID: ] - PubMed
Tamayo 2009 {published data only}
    1. Tamayo E, Alonso O, Alvarez FJ, Castrodeza J, Florez S, di Stefano S. Effects of simvastatin on acute-phase protein levels after cardiac surgery [Efecto de la simvastatina en la concentration de las proteinas de fase aguda despues de la cirugia cardiaca]. Medicina Clinica 2008;130(20):773-5. [PMID: ] - PubMed
    1. Tamayo E, Alvarez FJ, Alonso O, Bustamante R, Castrodeza J, Soria S, et al. Effects of simvastatin on systemic inflammatory responses after cardiopulmonary bypass. Journal of Cardiovascular Surgery 2009;50(5):687-94. [PMID: ] - PubMed
Thielmann 2007 {published data only}
    1. Thielmann M, Neuhauser M, Marr A, Jaeger BR, Wendt D, Schuetze B, et al. Lipid-lowering effect of preoperative statin therapy on postoperative major adverse cardiac events after coronary artery bypass surgery. Journal of Thoracic and Cardiovascular Surgery 2007;134(5):1143-9. [PMID: ] - PubMed
Virani 2008 {published data only}
    1. Virani SS, Nambi V, Razavi M, Lee VV, Elayda M, Wilson JM, et al. Preoperative statin therapy is not associated with a decrease in the incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery. American Heart Journal 2008;155(3):541-6. [PMID: ] - PubMed
Yin 2010 {published data only}
    1. Yin L, Wang Z, Wang Y, Ji G, Xu Z. Effect of statins in preventing postoperative atrial fibrillation following cardiac surgery. Heart, Lung & Circulation 2010;19(10):579-83. [PMID: ] - PubMed
Youn 2011 {published data only}
    1. Youn YN, Park SY, Hwang Y, Joo HC, Yoo KJ. Impact of high-dose statin pretreatment in patients with stable angina during off-pump coronary artery bypass. Korean Journal of Thoracic and Cardiovascular Surgery 2011;44(3):208-14. [PMID: ] - PMC - PubMed
Yu 2011 {published data only}
    1. Yu XL, Zhang HJ, Ren SD, Geng J, Wu TT, Chen WQ, et al. Effects of loading dose of atorvastatin before percutaneous coronary intervention on periprocedural myocardial injury. Coronary Artery Disease 2011;22(1):87-91. [PMID: ] - PubMed
Zhang 2009 {published data only}
    1. Zhang M, Kang JP, Nie SP, Lv Q, Liu XH, Ma CS. Pre-hospital statin therapy may not reduce incidence of all-cause mortality and overall MACCE during hospital stay after coronary artery bypass graft surgery. Acta Cardiologica 2009;64(2):253-7. [PMID: ] - PubMed

References to ongoing studies

EUCTR2009‐013228‐21‐GB {unpublished data only}
    1. Prevention of atrial oxidative stress and electrical remodelling in patients undergoing cardiac surgery: randomised placebo-controlled trial of perioperative high-dose atorvastatin. trialsearch.who.int/Trial2.aspx?TrialID=EUCTR2009-013228-21-GB (first received 18 June 2010).
IRCT138711131630N1 {unpublished data only}138711131630N1
    1. IRCT138711131630N1. Effect of atorvastatin on the incidence of atrial fibrillation in patients undergoing coronary artery bypass graft surgery [Effect of atorvastatin on the incidence of atrial fibrillation in patients undergoing coronary artery bypass graft surgery]. trialsearch.who.int/Trial2.aspx?TrialID=IRCT138711131630N1 (first received 23 February 2013).
MIRACL IN CABG 2007 {published data only}
    1. MIRACL IN CABG – statins in cardiac surgery. Effect of doses on inflammatory response and early results. www.clinicaltrialsregister.eu/ctr-search/search?query=2006-005757-30 (first received 30 July 2007).
NCT01653223 {published and unpublished data}
    1. NCT01653223. Myocardial protection effect of simvastatin undergoing cardiac surgery. clinicaltrials.gov/study/NCT01653223 (first received 26 July 2012).

Additional references

Alexander 2008
    1. Alexander JH, Emery RW Jr, Carrier M, Ellis SJ, Mehta RH, Hasselblad V, et al. Efficacy and safety of pyridoxal 5'-phosphate (MC-1) in high-risk patients undergoing coronary artery bypass graft surgery: the MEND-CABG II randomized clinical trial. JAMA 2008;299(15):1777-87. [PMID: ] - PubMed
Alexander 2016
    1. Alexander JH, Smith PK. Coronary-artery bypass grafting. New England Journal of Medicine 2016;20:374. [DOI: 10.1056/NEJMra1406944] - DOI - PubMed
Alkhouli 2020
    1. Alkhouli M, Alqahtani F, Kalra A, Gafoor S, Alhajji M, Alreshidan M, et al. Trends in characteristics and outcomes of patients undergoing coronary revascularization in the United States. JAMA Network Open 2020;3(2):2. [DOI: 10. 1001/jamanetworkopen.2019. 21326] - PubMed
Beckmann 2020
    1. Beckmann A, Meyer R, Lewandowski J, Markewitz A, Gummert J. German heart surgery report 2019: the annual updated registry of the German Society for Thoracic and Cardiovascular Surgery. Thoracic and Cardiovascular Surgeon 2020;68:263-76. [DOI: 10.1055/s-0040-1710569] - DOI - PubMed
Bestehorn 2015
    1. Bestehorn K, Bauer T, Fleck E, Bestehorn M, Pauletzki J, Hamm C. Coronary procedures in German hospitals: a detailed analysis for specific patient clusters. Clinical Research in Cardiology 2015;104:555-65. [DOI: 10.1007/s00392-015-0818-3] - DOI - PubMed
Bourbon 2004
    1. Bourbon A, Vionnet M, Leprince P, Vaissier E, Copeland J, McDonagh P, et al. The effect of methylprednisolone treatment on the cardiopulmonary bypass-induced systemic inflammatory response. European Journal of Cardio-thoracic Surgery 2004;26(5):932-8. [PMID: ] - PubMed
Brugts 2009
    1. Brugts JJ, Yetgin T, Hoeks SE, Gotto AM, Shepherd J, Westendorp RG, et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ (Clinical Research Ed.) 2009;338:b2376. [PMID: ] - PMC - PubMed
Chen 2010
    1. Chen WT, Krishnan GM, Sood N, Kluger J, Coleman CI. Effect of statins on atrial fibrillation after cardiac surgery: a duration- and dose-response meta-analysis. Journal of Thoracic and Cardiovascular Surgery 2010;140(2):364-72. [PMID: ] - PubMed
Clark 2006
    1. Clark LL, Ikonomidis JS, Crawford FA Jr, Crumbley A III, Kratz JM, Stroud MR, et al. Preoperative statin treatment is associated with reduced postoperative mortality and morbidity in patients undergoing cardiac surgery: an 8-year retrospective cohort study. Journal of Thoracic and Cardiovascular Surgery 2006;131(3):679-85. - PubMed
Coleman 2007
    1. Coleman CI, Lucek DM, Hammond J, White CM. Preoperative statins and infectious complications following cardiac surgery. Current Medical Research and Opinion 2007;23(8):1783-90. - PubMed
Deng 1996
    1. Deng MC, Dasch B, Erren M, Mollhoff T, Scheld HH. Impact of left ventricular dysfunction on cytokines, hemodynamics, and outcome in bypass grafting. Annals of Thoracic Surgery 1996;62(1):184-90. [PMID: ] - PubMed
Di Sciascio 2009
    1. Di Sciascio G, Patti G, Pasceri V, Gaspardone A, Colonna G, Montinaro A. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: results of the ARMYDA-RECAPTURE (Atorvastatin for Reduction of Myocardial Damage During Angioplasty) randomized trial. Journal of the American College of Cardiology 2009;54(6):558-65. [PMID: ] - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Research Ed.) 1997;315(7109):629-34. [PMID: ] - PMC - PubMed
Guyatt 2011
    1. Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. Journal of Clinical Epidemiology 2011;64(4):380-2. - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Hindler 2006
    1. Hindler K, Shaw AD, Samuels J, Fulton S, Collard CD, Riedel B. Improved postoperative outcomes associated with preoperative statin therapy. Anesthesiology 2006;105(6):1260-72. - PubMed
Kapoor 2006
    1. Kapoor AS, Kanji H, Buckingham J, Devereaux PJ, McAlister FA. Strength of evidence for perioperative use of statins to reduce cardiovascular risk: systematic review of controlled studies. BMJ 2006;333(7579):1149. - PMC - PubMed
Knatterud 2000
    1. Knatterud GL, Rosenberg Y, Campeau L, Geller NL, Hunninghake DB, Forman SA, et al. Long-term effects on clinical outcomes of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation in the post coronary artery bypass graft trial. Post CABG Investigators. Circulation 2000;102(2):157-65. - PubMed
Kuhn 2014
    1. Kuhn EW, Liakopoulos OJ, Stange S, Deppe AC, Slottosch I, et al. Preoperative statin therapy in cardiac surgery: a meta-analysis of 90,000 patients. European Journal of Cardiothoracic Surgery 2014;45:17-26. [DOI: 10.1093/ejcts/ezt181] [PMID: ] - DOI - PubMed
Kulik 2007
    1. Kulik A, Levin R, Ruel M, Mesana TG, Solomon DH, Choudhry NK. Patterns and predictors of statin use after coronary artery bypass graft surgery. Journal of Thoracic and Cardiovascular Surgery 2007;134(4):932-8. - PubMed
Lazar 2003
    1. Lazar HL, Bao Y, Zhang Y, Bernard SA. Pretreatment with statins enhances myocardial protection during coronary revascularization. Journal of Thoracic and Cardiovascular Surgery 2003;125(5):1037-42. - PubMed
Lefebvre 2019
    1. Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (updated July 2019). Cochrane, 2019. Available from training.cochrane.org/handbook/archive/v6. [PMID: ]
Liakopoulos 2005
    1. Liakopoulos OJ, Muhlfeld C, Koschinsky M, Coulibaly MO, Schondube FA, Dorge H. Progressive loss of myocardial contractile function despite unimpaired coronary blood flow after cardiac surgery. Basic Research in Cardiology 2005;100(1):75-83. [PMID: ] - PubMed
Liakopoulos 2006a
    1. Liakopoulos OJ, Teucher N, Muhlfeld C, Middel P, Heusch G, Schoendube FA, et al. Prevention of TNFalpha-associated myocardial dysfunction resulting from cardiopulmonary bypass and cardioplegic arrest by glucocorticoid treatment. European Journal of Cardio-thoracic Surgery 2006;30(2):263-70. [PMID: ] - PubMed
Liakopoulos 2007
    1. Liakopoulos OJ, Schmitto JD, Kazmaier S, Brauer A, Quintel M, Schoendube FA, et al. Cardiopulmonary and systemic effects of methylprednisolone in patients undergoing cardiac surgery. Annals of Thoracic Surgery 2007;84(1):110-8; discussion 118-9. [PMID: ] - PubMed
Liakopoulos 2008
    1. Liakopoulos OJ, Choi YH, Haldenwang PL, Strauch J, Wittwer T, Dorge H, et al. Impact of preoperative statin therapy on adverse postoperative outcomes in patients undergoing cardiac surgery: a meta-analysis of over 30,000 patients. European Heart Journal 2008;29(12):1548-59. [PMID: ] - PubMed
Lindenauer 2004
    1. Lindenauer PK, Pekow P, Wang K, Gutierrez B, Benjamin EM. Lipid-lowering therapy and in-hospital mortality following major noncardiac surgery. JAMA 2004;291(17):2092-9. - PubMed
Ludman 2009
    1. Ludman A, Venugopal V, Yellon DM, Hausenloy DJ. Statins and cardioprotection – more than just lipid lowering? Pharmacology & Therapeutics 2009;122(1):30-43. [PMID: ] - PubMed
Mach 2020
    1. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al, ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Heart Journal 2020;41:111-88. [DOI: 10.1093/eurheartj/ehz455] - DOI - PubMed
Mohammed 2009
    1. Mohammed AA, Agnihotri AK, Kimmenade RR, Martinez-Rumayor A, Green SM, Quiroz R, et al. Prospective, comprehensive assessment of cardiac troponin T testing after coronary artery bypass graft surgery. Circulation 2009;120(10):843-50. [PMID: ] - PubMed
Moher 1999
    1. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 1999;354(9193):1896-900. [PMID: ] - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Medicine 2009;6(7):e1000097. [PMID: ] - PMC - PubMed
Mortensen 2018
    1. Mortensen MB, Falk E, Li D, Nasir K, Blaha MJ, Sandfort V, et al. Statin trials, cardiovascular events, and coronary artery calcification: implications for a trial-based approach to statin therapy in MESA. JACC Cardiovascular Imaging 2018;11:221-30. [DOI: 10.1016/j.jcmg.2017.01.029] - DOI - PMC - PubMed
Muhlfeld 2008
    1. Muhlfeld C, Liakopoulos OJ, Schaefer IM, Schondube FA, Richter J, Dorge H. Methylprednisolone fails to preserve pulmonary surfactant and blood-air barrier integrity in a porcine cardiopulmonary bypass model. Journal of Surgical Research 2008;146(1):57-65. [PMID: ] - PubMed
Oesterle 2017
    1. Oesterle A, Laufs U, Liao JK. Pleiotropic effects of statins on the cardiovascular system. Circulation Research 2017;120:229-43. [DOI: 10.1161/CIRCRESAHA.116.308537] - DOI - PMC - PubMed
Page 2019
    1. Page MJ, Higgins JP, Sterne JA. Chapter 13: Assessing risk of bias due to missing results in a synthesis. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (updated July 2019). Cochrane, 2019. Available from training.cochrane.org/handbook/archive/v6.
Paparella 2002
    1. Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. European Journal of Cardio-thoracic Surgery 2002;21(2):232-44. [PMID: ] - PubMed
Patti 2007
    1. Patti G, Pasceri V, Colonna G, Miglionico M, Fischetti D, Sardella G, et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. Journal of the American College of Cardiology 2007;49(12):1272-8. [PMID: ] - PubMed
Pendersen 2010
    1. Pedersen TR. Pleiotropic effects of statins: evidence against benefits beyond LDL-cholesterol lowering. American Journal of Cardiovascular Drugs 2010;10:10-7. [DOI: 10.2165/1158822-S0-000000000-00000] - DOI - PubMed
Pinho‐Gomes 2014
    1. Pinho-Gomes AC, Reilly S, Brandes RP, Casadei B. Targeting inflammation and oxidative stress in atrial fibrillation: role of 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibition with statins. Antioxidants & Redox Signaling 2014;20:1268-85. - PMC - PubMed
Poldermans 2003
    1. Poldermans D, Bax JJ, Kertai MD, Krenning B, Westerhout CM, Schinkel AF, et al. Statins are associated with a reduced incidence of perioperative mortality in patients undergoing major noncardiac vascular surgery. Circulation 2003;107(14):1848-51. - PubMed
Powell 2007
    1. Powell BD, Bybee KA, Valeti U, Thomas RJ, Kopecky SL, Mullany CJ, et al. Influence of preoperative lipid-lowering therapy on postoperative outcome in patients undergoing coronary artery bypass grafting. American Journal of Cardiology 2007;99(6):785-9. - PubMed
Pölzl 2022
    1. Pölzl L, Thielmann M, Cymorek S, Nägele F, Hirsch J, Graber M, et al. Impact of myocardial injury after coronary artery bypass grafting on long-term prognosis. European Heart Journal 2022;43(25):2407-17. [DOI: 10.1093/eurheartj/ehac054] - DOI - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: The Cochrane Collaboration, 2020.
Roberts 2016
    1. Roberts I, Ker K. Cochrane: the unfinished symphony of research synthesis. Systematic Reviews BMC 2016;5:115. [DOI: 10.1186/s13643-016-0290-9] - DOI - PMC - PubMed
Schouten 2009
    1. Schouten O, Boersma E, Hoeks SE, Benner R, Urk H, Sambeek MR, et al. Fluvastatin and perioperative events in patients undergoing vascular surgery. New England Journal of Medicine 2009;361(10):980-9. [PMID: ] - PubMed
Serruys 2009
    1. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. New England Journal of Medicine 2009;360(10):961-72. [PMID: ] - PubMed
Thakar 2003
    1. Thakar CV, Yared J-P, Worley S, Cotman K, Paganini EP. Renal dysfunction and serious infections after open-heart surgery. Kidney International 2003;64(1):239-46. [PMID: PubMed: 12787415] - PubMed
Valen 2000
    1. Valen G, Paulsson G, Bennet AM, Hansson GK, Vaage J. Gene expression of inflammatory mediators in different chambers of the human heart. Annals of Thoracic Surgery 2000;70(2):562-7. [PMID: ] - PubMed
Valen 2001
    1. Valen G, Yan ZQ, Hansson GK. Nuclear factor kappa-B and the heart. Journal of the American College of Cardiology 2001;38(2):307-14. [PMID: ] - PubMed
Verrier 2004
    1. Verrier ED, Shernan SK, Taylor KM, de Werf F, Newman MF, Chen JC, et al. Terminal complement blockade with pexelizumab during coronary artery bypass graft surgery requiring cardiopulmonary bypass: a randomized trial. JAMA 2004;291(19):2319-27. [PMID: ] - PubMed
Wallentin 2009
    1. Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. New England Journal of Medicine 2009;361(11):1045-57. - PubMed
Wan 2014
    1. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology 2014;14:135. [DOI: 10.1186/1471-2288-14-135] [PMID: ] - DOI - PMC - PubMed
White 2001
    1. White CW, Gobel FL, Campeau L, Knatterud GL, Forman SA, Forrester JS, et al. Effect of an aggressive lipid-lowering strategy on progression of atherosclerosis in the left main coronary artery from patients in the post coronary artery bypass graft trial. Circulation 2001;104(22):2660-5. - PubMed

References to other published versions of this review

Kuhn 2015
    1. Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ. Preoperative statin therapy for patients undergoing cardiac surgery. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No: CD008493. [DOI: 10.1002/14651858.CD008493.pub3] - DOI - PubMed
Kuhn 2016
    1. Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ. Preoperative statin therapy for patients undergoing cardiac surgery [withdrawn]. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No: CD008493. [DOI: 10.1002/14651858.CD008493.pub4] - DOI - PMC - PubMed
Liakoupoulos 2010
    1. Liakopoulos OJ, Kuhn EW, Slottosch I, Wassmer G, Wahlers T. Preoperative statin therapy for patients undergoing cardiac surgery. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No: CD008493. [DOI: 10.1002/14651858.CD008493] - DOI - PubMed
Liakoupoulos 2012
    1. Liakopoulos OJ, Kuhn EW, Slottosch I, Wassmer G, Wahlers T. Preoperative statin therapy for patients undergoing cardiac surgery. Cochrane Database of Systematic Reviews 2012, Issue 4. Art. No: CD008493. [DOI: 10.1002/14651858.CD008493.pub2] - DOI - PubMed

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