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American Journal of Cardiovascular Drugs

, Volume 16, Issue 3, pp 201–219 | Cite as

Efficacy of Short-Term Statin Treatment for the Prevention of Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography/Percutaneous Coronary Intervention: A Meta-Analysis of 21 Randomized Controlled Trials

  • Haixia Li
  • Cailian Wang
  • Chuanzhi Liu
  • Ruifei Li
  • Meijuan Zou
  • Gang ChengEmail author
Systematic Review

Abstract

Background

The results of previous studies have been contradictory in terms of the efficacy of statin treatment in preventing contrast-induced acute kidney injury (CI-AKI) and clinical adverse events (AEs).

Objective

This meta-analysis was undertaken to assess the role of short-term statin treatment in the prevention of CI-AKI and clinical AEs.

Methods

We searched the Cochrane Library, EMBASE, and PubMed databases for randomized controlled trials (RCTs) with the development of CI-AKI as a primary outcome. Secondary outcomes were the post-procedural serum creatinine (SCr) level, estimated glomerular filtration rate (eGFR), and development of AEs. We also performed prespecified subgroup analyses.

Results

A total of 21 RCTs involving 7746 patients were included. Short-term statin treatment significantly reduced the risk of CI-AKI [risk ratio (RR) 0.57; 95 % confident interval (CI) 0.47–0.69; p < 0.00001) and was associated with a lower post-procedural SCr level and a higher eGFR. High-dose statins resulted in a lower incidence of CI-AKI than the lower-dose statins. In addition, the benefit was seen across various subgroups for patients at risk of CI-AKI, statin-naïve patients, and East Asians, regardless of statin type, definition of CI-AKI, use of N-acetylcysteine (NAC) and hydration, and osmolality of contrast. However, there was no significant difference between the two groups in terms of the incidence of AEs.

Conclusions

The meta-analysis suggests that short-term statin treatment can effectively prevent CI-AKI, and the benefit is also observed in high-risk patients, statin-naïve patients, and an East Asian population. However, the effect of simvastatin for the prevention of CI-AKI, of statins for the prevention of AEs, and whether high-dose statins have a better effect than lower-dose statins are all still uncertain.

Keywords

Chronic Kidney Disease Statin Percutaneous Coronary Intervention Simvastatin Atorvastatin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors gratefully acknowledge Dr. David Jack for his assistance with language editing.

Compliance with Ethical Standards

Funding

No sources of funding were used to assist in the preparation of this study.

Conflicts of interest

Haixia Li, Cailian Wang, Chuanzhi Liu, Ruifei Li, Meijuan Zou, and Gang Cheng have no conflicts of interest that might be relevant to the contents of this study.

Supplementary material

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Supplementary material 1 (PDF 136 kb)
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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Haixia Li
    • 1
  • Cailian Wang
    • 2
  • Chuanzhi Liu
    • 3
  • Ruifei Li
    • 1
  • Meijuan Zou
    • 1
  • Gang Cheng
    • 1
    Email author
  1. 1.Shenyang Pharmaceutical UniversityShenyangChina
  2. 2.Department of CardiologyGeneral Hospital of Shenyang Military AreaShenyangChina
  3. 3.Department of NephrologyGeneral Hospital of Shenyang Military AreaShenyangChina

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