Fifteen RCTs were included in the review (2,292 participants). Seven RCTs were at low risk of bias, three were at high risk of bias and five had unclear risk of bias.
Perioperative statin treatment in patients who underwent cardiac surgery was associated with a significant reduction in the risk of atrial fibrillation compared with controls (RR 0.56, 95% CI 0.45 to 0.69; NNT=6; nine RCTs).
Perioperative statin treatment in patients who underwent cardiac and noncardiac surgery was associated with a significant reduction in the risk of myocardial infarction compared with controls (RR 0.53, 95% CI 0.38 to 0.74; NNT=23; 10 RCTs) but not in the risk of death (RR 0.62, 95% CI 0.34 to 1.14; five RCTs).
Perioperative statin treatment was associated with a significant reduction in length of hospital stay compared with controls (SMD -0.32 days, 95% CI -0.53 to -0.11; 12 RCTs). There was no significant difference in length of intensive care unit stay between the two groups.
Significant heterogeneity was only observed on the outcome of length of hospital stay (Ι²=78.7%). There was no evidence of publication bias for most outcomes. Sensitivity and subgroup analyses did not materially alter most outcomes.