Introduction:
Contrast-induced nephropathy (CIN) is often encountered following percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) and is associated with high in- hospital morbidity and mortality. Statins may prevent the development of CIN, however their efficacy in patients with ACS has not been evaluated.
Hypothesis:
We conducted a meta-analysis of randomized controlled trials (RCTs) to assess statin efficacy in the prevention of CIN in patients undergoing PCI for ACS.
Methods:
PubMed, EMBASE, MEDLINE and the Cochrane Central Register were searched for RCTs from inception to September 2014 to compare high-dose statins (rosuvastatin 40mg/day, atorvastatin 80mg/day or simvastatin 80mg/day) with low-dose (atorvastatin 10mg/day, simvastatin 10mg/day) o placebo treatment in patients with ACS, undergoing PCI. Study-specific odds ratios (ORs) were calculated, and between-study heterogeneity was assessed using the I2 statistic. We used a random effects model meta-analysis to pool the OR.
Results:
Seven RCTs, including 5174 patients were included in the analysis. CIN occurred in 126 (4.9 patients in the high dose statin group and in 232 (8.9%) patients in the low dose or placebo group (OR: 0.50, 95% confidence interval: 0.38- 0.66, p<0.001). The observed heterogeneity between the included studies was low (I2=19%, p=0.28).
Conclusions:
High-dose statin therapy is effective at preventing the development of CIN in the high-risk population of patients undergoing PCI for ACS.
Short term outcomes in the elderly patients with non-ST-elevation acute coronary syndromes undergoing early percutaneous coronary intervention: a report from the ISACS-TC registry
