Fluvastatin and Perioperative Events in Patients Undergoing Vascular Surgery
Open accessAbstract
BACKGROUND: Adverse cardiac events are common after vascular surgery. We hypothesized that perioperative statin therapy would improve postoperative outcomes. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned patients who had not previously been treated with a statin to receive, in addition to a beta-blocker, either 80 mg of extended-release fluvastatin or placebo once daily before undergoing vascular surgery. Lipid, interleukin-6, and C-reactive protein levels were measured at the time of randomization and before surgery. The primary end point was the occurrence of myocardial ischemia, defined as transient electrocardiographic abnormalities, release of troponin T, or both, within 30 days after surgery. The secondary end point was the composite of death from cardiovascular causes and myocardial infarction. RESULTS: A total of 250 patients were assigned to fluvastatin, and 247 to placebo, a median of 37 days before vascular surgery. Levels of total cholesterol, low-density lipoprotein cholesterol, interleukin-6, and C-reactive protein were significantly decreased in the fluvastatin group but were unchanged in the placebo group. Postoperative myocardial ischemia occurred in 27 patients (10.8%) in the fluvastatin group and in 47 (19.0%) in the placebo group (hazard ratio, 0.55; 95% confidence interval [CI], 0.34 to 0.88; P=0.01). Death from cardiovascular causes or myocardial infarction occurred in 12 patients (4.8%) in the fluvastatin group and 25 patients (10.1%) in the placebo group (hazard ratio, 0.47; 95% CI, 0.24 to 0.94; P=0.03). Fluvastatin therapy was not associated with a significant increase in the rate of adverse events. CONCLUSIONS: In patients undergoing vascular surgery, perioperative fluvastatin therapy was associated with an improvement in postoperative cardiac outcome. (Current Controlled Trials number, ISRCTN83738615.)
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Dyslipidaemias are very common in recipients of heart, lung, liver, kidney, or blood-forming stem cell transplants.
“Dyslipidaemias are very common in patients who have undergone heart, lung, liver, kidney, or allogenic haematopoietic stem cell transplantation, and predispose such patients to an increased risk of developing ASCVD and transplant arterial vasculopathy [497-501].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [499]
These dyslipidaemias increase the risk of atherosclerotic cardiovascular disease and transplant arterial vasculopathy in transplant recipients.
“Dyslipidaemias are very common in patients who have undergone heart, lung, liver, kidney, or allogenic haematopoietic stem cell transplantation, and predispose such patients to an increased risk of developing ASCVD and transplant arterial vasculopathy [497-501].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [499]
In another double-blind placebo-controlled trial in 497 patients undergoing vascular surgery, perioperative fluvastatin 80 mg/day was associated with improvement in post-operative cardiac outcome.
“In another double-blind placebo-controlled trial in 497 patients undergoing vascular surgery, perioperative fluvastatin therapy (80 mg/day) was associated with an improvement in post-operative cardiac outcome.209”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [209]
There is no conclusive evidence that statin treatment reduces perioperative cardiovascular disease morbidity and mortality in patients with abdominal aortic aneurysm.
“Although abdominal aortic aneurysm is also a CHD risk-equivalent condition, there is no conclusive evidence that treatment with statins reduces perioperative CVD morbidity and mortality in these patients.220,487”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [487]
Abdominal aortic aneurysm is a coronary heart disease risk-equivalent condition.
“Although abdominal aortic aneurysm is also a CHD risk-equivalent condition, there is no conclusive evidence that treatment with statins reduces perioperative CVD morbidity and mortality in these patients.220,487”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [487]
In another double-blind placebo-controlled trial in 497 patients undergoing vascular surgery, perioperative fluvastatin 80 mg/day was associated with improvement in postoperative cardiac outcome.
“In another double-blind placebocontrolled trial in 497 patients undergoing vascular surgery, perioperative fluvastatin therapy (80 mg/day) was associated with an improvement in postoperative cardiac outcome.418”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [418]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)
Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., & Fowkes, F. G. R. (2007) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2006.12.037 · Cited by 8,191 · see citing works
Universal Definition of Myocardial Infarction
Thygesen, K. A., Alpert, J. S., White, H. D., TASK FORCE MEMBERS: Chairpersons: Kristian Thygesen (Denmark), J. S. A. (., Biomarker Group: Allan S. Jaffe, C. (., ECG Group: Bernard Chaitman, C.-O. (., Imaging Group: Richard Underwood, C. (., Intervention Group: Jean-Pierre Bassand, C.-O. (., Mendis, S., Implementation Group: Lars C. Wallentin Coordinator (Sweden), F. F.-A. (., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.187397 · Cited by 4,422 · see citing works
Hirsch, A. T., Haskal, Z. J., Hertzer, N. R., Bakal, C. W., Creager, M. A., Halperin, J. L., Hiratzka, L. F., Murphy, W. R. C., Olin, J. W., Puschett, J. B., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.174526 · Cited by 3,708 · see citing works
From Vulnerable Plaque to Vulnerable Patient
Naghavi, M., Libby, P., Falk, E., Casscells, S. W., Litovsky, S. H., Rumberger, J. A., Badimón, J. J., Stefanadis, C., Moreno, P., Pasterkamp, G., et al. (2003) · Circulation · doi:10.1161/01.cir.0000087481.55887.c9 · Cited by 2,686 · see citing works
Task Force Members, Thygesen, K. A., Alpert, J. S., White, H. D., Biomarker Group, Jaffe, A. S., Apple, F. S., Galvani, M., Katus, H. A., Newby, L. K., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm355 · Cited by 2,536 · see citing works
Self-citationC-Reactive Protein Levels and Outcomes after Statin Therapy
Ridker, P. M., Cannon, C. P., Morrow, D., Rifai, N., Rose, L. M., McCabe, C. H., Pfeffer, M. A., & Braunwald, E. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa042378 · Cited by 2,292 · see citing works
From Vulnerable Plaque to Vulnerable Patient
Naghavi, M., Libby, P., Falk, E., Casscells, S. W., Litovsky, S. H., Rumberger, J. A., Badimón, J. J., Stefanadis, C., Moreno, P., Pasterkamp, G., et al. (2003) · Circulation · doi:10.1161/01.cir.0000087480.94275.97 · Cited by 2,270 · see citing works
Coronary Artery Disease in Peripheral Vascular Patients
HERTZER, N. R., Beven, E. G., Young, J. R., O’Hara, P. J., Ruschhaupt, W. F., Graor, R. A., deWolfe, V. G., & Maljovec, L. C. (1984) · Annals of Surgery · doi:10.1097/00000658-198402000-00016 · Cited by 1,341 · see citing works
Perioperative Cardiac Morbidity
Mangano, D. T. (1990) · Anesthesiology · doi:10.1097/00000542-199001000-00025 · Cited by 1,178 · see citing works
ACC/AHA/NHLBI Clinical Advisory on the Use and Safety of Statins
Writing Committee Members:, Pasternak, R. C., Smith, S. C., Bairey-Merz, C. N., Grundy, S. M., Cleeman, J. I., & Lenfant, C. (2002) · Circulation · doi:10.1161/01.cir.0000032466.44170.44 · Cited by 1,088 · see citing works
Hirsch, A. T., Haskal, Z. J., HERTZER, N. R., Bakal, C. W., Creager, M. A., Halperin, J. L., Hiratzka, L. F., Murphy, W. R. C., Olin, J. W., Puschett, J. B., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.10.009 · Cited by 1,023 · see citing works
Cannon, C. P., Battler, A., Brindis, R. G., Cox, J. L., Ellis, S. G., Every, N. R., Flaherty, J. T., Harrington, R. A., Krumholz, H. M., Simoons, M. L., et al. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01702-8 · Cited by 673 · see citing works
Reduction in cardiovascular events after vascular surgery with atorvastatin: a randomized trial
Durazzo, A. E. S., Machado, F. S., Ikeoka, D. T., De Bernoche, C., Monachini, M. C., Puech-Leão, P., & Caramelli, B. (2004) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2004.01.004 · Cited by 595 · see citing works
UNIVERSAL DEFINITION OF MYOCARDIAL INFARCTION
Thygesen, K. A., Alpert, J. S., & White, H. (2008) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2008-4-5-91-105 · Cited by 527 · see citing works
Pasternak, R. C., Smith, S. C., Merz, C. N. B., Grundy, S. M., Cleeman, J. I., & Lenfant, C. J. M. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02030-2 · Cited by 497 · see citing works
Landesberg, G., Shatz, V., Akopnik, I., et al. (2003) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.05.001 · Cited by 492 · see citing works
Withdrawal of Statins Increases Event Rates in Patients With Acute Coronary Syndromes
Heeschen, C., Hamm, C. W., Laufs, U., Snapinn, S. M., Böhm, M., & White, H. D. (2002) · Circulation · doi:10.1161/01.cir.0000012530.68333.c8 · Cited by 480 · see citing works
Poldermans, D., Bax, J. J., Kertai, M. D., Krenning, B. J., Westerhout, C. M., Schinkel, A. F. L., Thomson, I. R., Lansberg, P. J., Fleisher, L. A., Klein, J., et al. (2003) · Circulation · doi:10.1161/01.cir.0000066286.15621.98 · Cited by 471 · see citing works
Self-citationLipid-Lowering Therapy and In-Hospital Mortality Following Major Noncardiac Surgery
Lindenauer, P. K. (2004) · JAMA · doi:10.1001/jama.291.17.2092 · Cited by 467 · see citing works
Dawood, M. M., Gutpa, D. K., Southern, J. F., Walia, A., Atkinson, J. B., & Eagle, K. A. (1996) · International Journal of Cardiology · doi:10.1016/s0167-5273(96)02769-6 · Cited by 358 · see citing works
Katsimaglis, G., Danias, P. G., Danias, P. G., O'Neil-Callahan, K., Ryan, J. W., Mosby, C., Danias, P. G., Katsimaglis, G., Ioannidis, J. P. A., Ioannidis, J. P. A., et al. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.10.048 · Cited by 271 · see citing works
Histological Analysis of Coronary Artery Lesions in Fatal Postoperative Myocardial Infarction
Cohen, M. C., & Aretz, T. H. (1999) · Cardiovascular Pathology · doi:10.1016/s1054-8807(98)00032-5 · Cited by 268 · see citing works
Poldermans, D., Bax, J. J., Schouten, O., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.03.059 · Cited by 264 · see citing works
Self-citationAssociation of Statin Therapy with Outcomes of Acute Coronary Syndromes: The GRACE Study
Spencer, F. A., Allegrone, J., Goldberg, R. J., et al. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-11-200406010-00006 · Cited by 213 · see citing works
Halcox, J., & Deanfield, J. E. (2004) · Circulation · doi:10.1161/01.cir.0000129500.29229.92 · Cited by 200 · see citing works
Kertai, M. D., Boersma, E. H., Westerhout, C. M., Klein, J., van Urk, H., Bax, J. J., Roelandt, J. R. T. C., & Poldermans, D. (2004) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2004.07.008 · Cited by 194 · see citing works
Self-citationSeries of Monographs on Venous Thromboembolic Disease
Jaff, M. R., & Halperin, J. L. (2004) · Circulation · doi:10.1161/01.cir.0000122867.89751.59 · Cited by 126 · see citing works
Statins for the prevention of perioperative cardiovascular complications in vascular surgery
Schouten, O., Bax, J. J., Dunkelgrün, M., Feringa, H. H. H., van Urk, H., & Poldermans, D. (2006) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2006.04.039 · Cited by 56 · see citing works
Self-citationBaigent, C., KEECH, A. C., Kearney, P. M., et al. (2008) · The Lancet · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Cannon CP, Battler A, Brindis RG, et al. 8. American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of pa- tients with acute coronary syndromes: a re- port of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Com- mittee). J Am Coll Cardiol 2001;38:2114-30.
- Walia A, Atkinson JB, Eagle KA. Patholo- gy of fatal perioperative myocardial in- farction: implications regarding pathophys- iology and prevention. Int J Cardiol 1996; 57:37-44.
Cited by
Sorted by citations
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490 · see citing works
Self-citationMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854 · see citing works
ESC/EAS Guidelines for the management of dyslipidaemias
Reiner, Ž., Catapano, A. L., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr158 · Cited by 3,549 · see citing works
Self-citation2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw272 · Cited by 3,162 · see citing works
Self-citation2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.08.018 · Cited by 1,582 · see citing works
ESC/EAS Guidelines for the management of dyslipidaemias
Catapano, A. L., Reiner, Ž., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.06.028 · Cited by 706 · see citing works
Nguyen, T.-L., Collins, G. S., Spence, J., Daurès, J.-P., Devereaux, P. J., Landais, P., & Le Manach, Y. (2017) · BMC Medical Research Methodology · doi:10.1186/s12874-017-0338-0 · Cited by 512 · see citing works
ESC/EAS Guidelines for the management of dyslipidaemias
Catapano, A. L., Reiner, Ž., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.06.012 · Cited by 192 · see citing works
- Authors
- Schouten, O., Boersma, E., Hoeks, S. E., Benner, R., van Urk, H., van Sambeek, M. R. H. M., Verhagen, H. J. M., Khan, N. A., Dunkelgrun, M., Bax, J. J., & Poldermans, D.
- Affiliations
- Erasmus MC (NL)
- Leiden University Medical Center (NL)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2009-09-03
- Volume
- 361
- Issue
- 10
- Pages
- 980-989
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2144623639
- Cited by
- 374
- References
- 30
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 11 · 2020: 15 · 2019: 13 · 2018: 10 · 2017: 24 · 2016: 28 · 2015: 18 · 2014: 32 · 2013: 29 · 2012: 56
- FWCI
- 37.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Funders
- Bristol-Myers Squibb
- Boston Scientific Corporation
- European Society of Cardiology
- Erasmus Medisch Centrum
- St. Jude Medical
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- fluvastatin, perioperative statin therapy, vascular surgery, postoperative myocardial ischemia, cardiovascular mortality, myocardial infarction, beta-blockers, interleukin-6, C-reactive protein, lipid lowering, troponin T
- MeSH terms
- Fluvastatin, Adrenergic beta-Antagonists, C-Reactive Protein, Cardiovascular Diseases, Cholesterol, Double-Blind Method, Electrocardiography, Fatty Acids, Monounsaturated, Humans, Indoles, Postoperative Period, Vascular Surgical Procedures, Interleukin-6, Myocardial Ischemia, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Perioperative Care, Troponin T, Kaplan-Meier Estimate
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
