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Meta-Analysis of Randomized Controlled Trials of Preprocedural Statin Administration for Reducing Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Catheterization.
- Source :
-
American Journal of Cardiology . 2014, Vol. 114 Issue 4, p541-548. 8p. - Publication Year :
- 2014
-
Abstract
- Preprocedural statin administration may reduce contrast-induced acute kidney injury (CI-AKI), but current evidence is controversial. Randomized controlled trials (RCTs) comparing preprocedural statin administration before coronary catheterization with standard strategies were searched in MEDLINE/PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and ScienceDirect databases. The outcome of interest was the incidence of postprocedural CI-AKI. Prespecified subgroup analyses were performed according to baseline glomerular filtration rate (GFR), statin type, and N-acetylcysteine use. Eight RCTs were included for a total of 4,984 patients. The incidence of CI-AKI was 3.91% in the statin group (n = 2,480) and 6.98% in the control group (n = 2,504). In the pooled analysis using a random-effects model, patients receiving statins had 46% lower relative risk (RR) of CI-AKI compared with the control group (RR 0.54, 95% confidence interval [CI] 0.38 to 0.78, p = 0.001). A moderate degree of non-significant heterogeneity was present (I2 = 41.9%, chisquare = 12.500, p = 0.099, τ2 = 0.100). In the subanalysis based on GFR, the pooled RR indicated a persistent benefit with statins in patients with GFR <60 ml/min (RR 0.67, 95% CI 0.45 to 1.00, p = 0.050) and a highly significant benefit in patients with GFR ≥60 ml/min (RR 0.40, 95% CI 0.27 to 0.61, p <0.0001). Statin type and N-acetylcysteine or hydration did not significantly influence the results. In conclusion, preprocedural statin use leads to a significant reduction in the pooled RR of CI-AKI. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00029149
- Volume :
- 114
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- American Journal of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 97313726
- Full Text :
- https://doi.org/10.1016/j.amjcard.2014.05.036