Systematic review/meta-analysisHigh-Dose Statin Pretreatment for the Prevention of Contrast-Induced Nephropathy: A Meta-analysis
Section snippets
Materials and Methods
Our prespecified inclusion criteria were as follows: the subjects were adults; the reports were in the English or Chinese language literature; high-dose statins a priori (defined as a daily dose of 80 mg or 40 mg12, 13) were administered; periprocedural administration was described as immediately preceding or within 24 hours of the planned contrast exposure; prospective trials were of individuals randomized to statin, administered orally, vs a control group; and trials included the incidence of
Description of studies
Of the 67 potentially relevant reports initially screened, a total of 8 trials were identified.7, 8, 9, 10, 11, 15, 16, 17 Eight trials with a total of 1423 patients (695 assigned to high-dose statin and 728 assigned to the control arm) were included, and the relevant data extracted. The characteristics of included trials are described in Table 1, Table 2, Table 3, Table 4. Five trials in English and 3 trials in Chinese were retrieved with full text of journal articles. The subject population
Discussion
The present meta-analysis based on currently available published randomized clinical trials demonstrates that the administration of high-dose statin pretreatment is superior to low-dose statin or placebo in preventing CIN among patients undergoing diagnostic and interventional procedures requiring contrast media. In addition, short-term prophylaxis with high-dose statin therapy tended to be associated with reduction in serum creatinine after coronary artery angiography. However, subgroup
Conclusions
The present analysis suggests that statins at individual periprocedural doses 80 mg or 40 mg per day decrease the incidence of CIN (none of the trials reported significant side effects). Further prospective studies are needed to better understand the value of high-dose statins in protecting against CIN.
Disclosures
The authors have no conflicts of interest to disclose.
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