Table 1.
Description of included studies
| Study (design) | Sample size (mean age) | Study population and types of surgery | Statin use | Patients with dyslipidaemia (%) | Patients using aspirin or other antiplatelet agent, or β blockers (%) | Outcomes | Follow-up |
|---|---|---|---|---|---|---|---|
| Non-cardiac surgery: | |||||||
| Boersma et al 2001w15 (prospective cohort) | 1351 (NR) | Consecutive patients scheduled for elective major vascular surgery (47% aortic femoral bypass, 35% infrainguinal reconstruction) | Taking “lipid lowering agents” before operation | NR | 30, 27 | Cardiac death or non-fatal acute coronary syndrome detected by routine clinical care* | 1 month |
| Poldermans et al 2003w6 (case control) | 480 (70) | Patients undergoing major vascular surgery (38% repair of acute abdominal aortic aneurysm, 48% elective repair of abdominal aortic aneurysm, 11% revascularisation of legs) from 1991-2000 | Taking statins before operation | 45 | 26, 30 | Death from any cause within 30 days of surgery | 1 month |
| Landesberg et al 2003w17 (retrospective cohort) | 502 (66) | Consecutive patients undergoing elective vascular operations (60% infrainguinal bypass, 38% repair of abdominal aortic aneurysm, 2% axillofemoral bypass) from 1990-9 | Taking lipid lowering therapy before operation | 21 | NR, 15 | Death from any cause | 1 month and long term |
| Durazzo et alw1 2004 (randomised controlled trial) | 100 (NR) | Patients for elective non-cardiac vascular surgery (56% aortic repair, 20% infrainguinal arterial bypass, 11% carotid endarterectomy), no recent acute coronary syndrome or stroke, recruited between 1999 and 2000 | Taking statins for at least 14 days before operation | 63 | 39, 60 | Cardiac death; non-fatal acute coronary syndromes or ischaemic stroke, or both detected by routine physical examinations, electrocardiography, and cardiac biomarkers done postoperatively for seven days. After discharge, only symptomatic events detected† | 10 days and 6 months |
| Lindenauer et alw7 2004 (retrospective cohort) | 780 591 (64) | Patients who survived beyond postoperative day 2 after non-cardiac surgery (50% of surgery elective and types of surgery: 36% orthopaedic, 32% abdominal, 8% vascular) from 2000-1 | Taking lipid lowering therapy in first two days after admission to hospital (91% statins) | 5 | 11, 19 | In-hospital mortality (average stay five days) | Admission to hospital |
| Kertai et al 2004w13 (retrospective cohort) | 570 (68) | Patients undergoing elective surgery for infrarenal abdominal aortic aneurysm between 1991 and 2000 | Taking statins before operation | NR | 23, 45 | All cause mortality and myocardial infarction detected by routine electrocardiography and cardiac biomarkers done postoperatively for seven days. After discharge, only symptomatic events detected† | 1 month |
| Abbruzzese et al 2004w10 (retrospective cohort) | 189 operations, 172 patients (69) | Consecutive patients who underwent infrainguinal arterial reconstruction from 1999-2001 | Taking statins before operation | NR | 63, NR | All cause mortality and myocardial infarction extracted from chart review* | 1 month |
| O'Neil-Callahan et al 2005w2 (retrospective cohort) | 1163 operations, 997 patients (71) | Consecutive patients who underwent carotid endarterectomy (31%), aortic surgery (15%) or revascularisation of the legs (54%) from 1999-2000 (84% elective) | Taking statins before operation | 52 | 52, 49 | Death and acute coronary syndrome extracted from chart review* | Admission to hospital |
| Schouten et al 2005w8 (retrospective cohort) | 981 (67) | Consecutive patients undergoing elective major vascular surgery from 1998-2004 (60% repair of abdominal aortic aneurysm, 40% revascularisation of the legs) | Taking statins before operation (average 40 days) | NR | NR, NR | Myopathy, death, or acute coronary syndrome detected by routine electrocardiography and cardiac biomarkers done postoperatively for seven days | 7 days |
| Kennedy et al 2005w5 (retrospective cohort) | 3283 (72) | Consecutive patients undergoing carotid endarterectomy (62% symptomatic) from 2000-1 | Taking statins before operation | NR | NR, NR | Mortality, stroke, or acute coronary syndromes extracted from chart review* | Admission to hospital |
| McGirt et al 2005w3 (retrospective cohort) | 1566 (72) | Consecutive patients undergoing carotid endarterectomy (42% symptomatic) from 1994-2004 | Taking statins for at least seven days before operation | 50 | NR, NR | Mortality, stroke, or acute coronary syndromes extracted from chart review* | 1 month |
| Ward et al 2005w9 (retrospective cohort) | 446 (67) | Consecutive patients undergoing infrainguinal vascular bypass surgery from 1995-2001 because of atherosclerotic disease | Taking statins before operation | NR | NR, 21 | Mortality, stroke, acute coronary syndromes, or major vascular complications extracted from chart review* | 1 month |
| Amar et al 2005w18 (prospective cohort) | 131 (71) | Patients aged 60 years or older undergoing elective major thoracic surgery from 2002-3 (89% lobectomy, 7% oesophagectomy, 4% pneumonectomy) | Taking statins before operation | NR | NR, 22 | Death within 30 days, atrial fibrillation, stroke extracted from hospital and physician records | 1 month |
| Conte et al 2005w16 (prospective cohort in setting of randomised controlled trial) | 1404 (69) | Patients undergoing infrainguinal revascularisation for critical limb ischaemia and enrolled in a randomised trial testing ex vivo application of edifoligide to vein grafts before implantation | Taking statins before operation | 55 | 50, 49 | Mortality, acute coronary syndromes, and stroke collected prospectively within trial setting | 1 month |
| Cardiac surgery: | |||||||
| Christenson 1999w14 (randomised controlled trial) | 77 (63) | Consecutive patients undergoing coronary artery bypass grafting surgery (87% elective) between 1997 and 1998 | Taking statins for four weeks before operation | 62 | NR, NR | Acute coronary syndrome detected by routine electrocardiography and cardiac biomarkers done postoperatively for seven days. After discharge, only symptomatic events detected† | 7 days and 12 months |
| Dotani et al 2000w12 (retrospective cohort) | 323 (63) | Consecutive elective patients undergoing coronary artery bypass grafting surgery in 1997 | Taking statins before operation | 50 | NR, NR | Cardiac death, acute coronary syndromes, stroke, arrhythmia, or heart failure extracted from chart review* | 2 months and 12 months |
| Pan et al 2004w11 (retrospective cohort) | 1663 (63) | Consecutive patients undergoing coronary artery bypass grafting surgery (81% elective) between 2000 and 2001 | Taking statins before operation | 66 | 51, 52 | All cause mortality, acute coronary syndrome, stroke, arrhythmias, or renal dysfunction extracted from chart review* | 1 month |
| Ali and Buth 2005w4 (retrospective cohort) | 5469 (NR) | Consecutive patients undergoing coronary artery bypass grafting surgery or valve surgery, or both (51% elective) from 1998-2003 | Taking statins before operation | NR | NR, 81 | Mortality, intra-aortic balloon pump use, or acute coronary syndrome (extracted from discharge records)* | 7 days |
NR=not reported.
*Thus clinically apparent cases only.
†That is, no routine surveillance.