Perioperative CareSTIMMNCT07575737
The Impact of Preoperative Statin Therapy and and Its Intensity on Postoperative and Mortality and Morbidity
An observational study of Perioperative Care, run by Karolinska Institutet at 2 sites in Sweden.
Trial summary
Statins are among the most widely prescribed drugs worldwide, and their benefits in cardiovascular risk reduction are well established. Beyond lipid lowering, statins exert pleiotropic effects - including anti-inflammatory, antioxidant, and endothelial-stabilizing properties - that have generated longstanding interest… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Perioperative Care
- How many people
- 70,000 participants
- Where
- 2 sitesSweden
- Study dates
- 14 May 2024to 2 Feb 2026
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: Adult patients (equal to or over 18 years) undergoing elective non-cardiac surgery
Who may be able to join
- Adults aged ≥ 18 years at the time of surgery
- Elective (non-emergency) surgical procedure
- Non-cardiac surgery (all surgical specialties except cardiac surgery)
Who cannot join
- Obstetric surgery
- Transplant surgery
- Planned day-case surgery (procedures with intended same-day discharge)
- Anesthetic monitoring episodes not involving a surgical procedure (e.g., anesthetic support for central venous catheter insertion)
- Urological brachytherapy
- Stereotactic radiosurgery (Gamma Knife or equivalent)
- Repeat or subsequent surgical procedures during the study period - only the index (chronologically first eligible) procedure per patient is included in the analysis
Trial locations and contacts
2 sites in 1 country.
Sweden2 sites
Karolinska University Hospital Huddinge
Stockholm
Karolinska University Hospital Solna
Stockholm
About this study
Official title: Impact of Statin Therapy and Intensity on Postoperative and Mortality and Morbidity: A Prospective Observational Dual-Centre Cohort Study
Statins are among the most widely prescribed drugs worldwide, and their benefits in cardiovascular risk reduction are well established. Beyond lipid lowering, statins exert pleiotropic effects - including anti-inflammatory, antioxidant, and endothelial-stabilizing properties - that have generated longstanding interest in their potential to mitigate perioperative complications.
Major surgery provokes a systemic inflammatory response, endothelial activation, and hemodynamic stress that may precipitate myocardial injury, organ dysfunction, and death, particularly in patients with pre-existing cardiovascular disease.
Therefore, the aim is to examine the association between preoperative statin therapy and its intensity with postoperative all-cause mortality and days at home alive after major non-cardiac surgery in a large, contemporary, dual center-based cohort.
Read the detailed description
Research hypothesis: Preoperative statin use is independently associated with reduced 30-day and 365-day all-cause mortality compared with no statin use. Higher statin intensity (high vs. low or moderate) is independently associated with reduced 30-day and 365-day all-cause mortality. Statin use and intensity are independently associated with greater DAH30 and DAH365, reflecting reduced postoperative morbidity
Background: Early randomised trials suggested that initiating statin therapy before surgery could reduce cardiac complications and mortality. However, several pivotal trials were subsequently retracted following research misconduct, undermining the evidence base for perioperative statin initiation and rendering clinical guidelines equivocal. Importantly, these discredited trials examined de novo short-term statin initiation - a question distinct from whether patients on established, chronic statin therapy experience better postoperative outcomes.
Subsequent observational studies have reported associations between preoperative statin use and reduced postoperative morbidity and mortality, but most have been limited by narrow surgical populations, and an inability to examine dose-response relationships, residual confounding or patient-centred outcomes beyond mortality.
Data collection and analysis: Data is collected prospectively between 2016 and 2023 across two tertiary academic centres - Karolinska University Hospital Solna and Huddinge - from electronic health records. Statin exposure status and intensity were ascertained from based on registered Anatomical Therapeutic Chemical (ATC) classification codes The primary analytical approach uses inverse probability of treatment weighting, implemented across two pre-specified binary analyses - statin use versus no use in the full cohort, and high versus low-moderate intensity within statin users, for more details see attached statistical analysis plan.
- Conditions
- Perioperative Care
What is being measured
The primary outcome is the main question the study is designed to answer.
30- and 365-day mortality
Death within the time frames described
Measured: 30 and 365 days respectively
Secondary outcomes (1)
DAH30 (Days At Home alive at 30 days) and DAH365 (Days At Home alive at 365 days)
DAH30: Patients who are hospitalized for 14 days postoperatively but are alive on day 30 will have DAH30=16. Patients who are hospitalized for five days, then discharged, but return after 10 days for an additional 11-day stay, will have DAH30=14. Anyone who dies within 30 days will have DAH30=0. This outcome measure is validated in several studies and has a significant advantage in that it correlates well with complications, even better than length of stay (LOS).
We will further record DAH365, calculated as described above.
Measured: 30 and 365 days after index surgery,
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2026
- Study start14 May 2024
- Primary completion2 Feb 2026
- Study completion2 Feb 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Perioperative CareStudies of the same condition, open and under way.
- More trials run by Karolinska InstitutetThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 70,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- Karolinska Institutet
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Arman Valadkhani, Karolinska Institutet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07575737
- Sponsor's protocol ID
- 2024-01664-01
- Acronym
- STIMM
- Status last verified
- May 2026
- First submitted
- 4 May 2026
- Last updated
- 13 May 2026
- Results posted
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 13 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Statin Therapy and Intensity on Postoperative and Mortality and Morbidity: A Prospective Observational Dual-Centre Cohort Study
- ClinicalTrials.gov ID
- NCT07575737
- Acronym / sponsor ID
- STIMM / 2024-01664-01
- Conditions
- Perioperative Care
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 70,000 participants (actual)
- Lead sponsor
- Karolinska InstitutetUniversity, hospital or other
- Study start
- 14 May 2024 (actual)
- Primary completion
- 2 Feb 2026 (actual)
- Study completion
- 2 Feb 2026 (actual)
- First posted
- 8 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Statins are among the most widely prescribed drugs worldwide, and their benefits in cardiovascular risk reduction are well established. Beyond lipid lowering, statins exert pleiotropic effects - including anti-inflammatory, antioxidant, and endothelial-stabilizing properties - that have generated longstanding interest in their potential to mitigate perioperative complications.
Major surgery provokes a systemic inflammatory response, endothelial activation, and hemodynamic stress that may precipitate myocardial injury, organ dysfunction, and death, particularly in patients with pre-existing cardiovascular disease.
Therefore, the aim is to examine the association between preoperative statin therapy and its intensity with postoperative all-cause mortality and days at home alive after major non-cardiac surgery in a large, contemporary, dual center-based cohort.
Detailed description
Research hypothesis: Preoperative statin use is independently associated with reduced 30-day and 365-day all-cause mortality compared with no statin use. Higher statin intensity (high vs. low or moderate) is independently associated with reduced 30-day and 365-day all-cause mortality. Statin use and intensity are independently associated with greater DAH30 and DAH365, reflecting reduced postoperative morbidity
Background: Early randomised trials suggested that initiating statin therapy before surgery could reduce cardiac complications and mortality. However, several pivotal trials were subsequently retracted following research misconduct, undermining the evidence base for perioperative statin initiation and rendering clinical guidelines equivocal. Importantly, these discredited trials examined de novo short-term statin initiation - a question distinct from whether patients on established, chronic statin therapy experience better postoperative outcomes.
Subsequent observational studies have reported associations between preoperative statin use and reduced postoperative morbidity and mortality, but most have been limited by narrow surgical populations, and an inability to examine dose-response relationships, residual confounding or patient-centred outcomes beyond mortality.
Data collection and analysis: Data is collected prospectively between 2016 and 2023 across two tertiary academic centres - Karolinska University Hospital Solna and Huddinge - from electronic health records. Statin exposure status and intensity were ascertained from based on registered Anatomical Therapeutic Chemical (ATC) classification codes The primary analytical approach uses inverse probability of treatment weighting, implemented across two pre-specified binary analyses - statin use versus no use in the full cohort, and high versus low-moderate intensity within statin users, for more details see attached statistical analysis plan.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- Adult patients (equal to or over 18 years) undergoing elective non-cardiac surgery
Key inclusion criteria (3 listed)
- Adults aged ≥ 18 years at the time of surgery
- Elective (non-emergency) surgical procedure
- Non-cardiac surgery (all surgical specialties except cardiac surgery)
Key exclusion criteria (7 listed)
- Obstetric surgery
- Transplant surgery
- Planned day-case surgery (procedures with intended same-day discharge)
- Anesthetic monitoring episodes not involving a surgical procedure (e.g., anesthetic support for central venous catheter insertion)
- Urological brachytherapy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
30- and 365-day mortality
Time frame: 30 and 365 days respectively
Death within the time frames described
1 secondary outcome
DAH30 (Days At Home alive at 30 days) and DAH365 (Days At Home alive at 365 days)
Time frame: 30 and 365 days after index surgery,
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 May 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Perioperative Care, run by Karolinska Institutet at 2 sites in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
30- and 365-day mortality (time frame: 30 and 365 days respectively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 May 2026.