OBJECTIVES: We assessed whether short-term, pre-procedural, intensive statin treatment may reduce contrast-induced acute kidney injury (CI-AKI) incidence in patients with and without acute coronary syndromes (ACS) undergoing coronary angiography (CA) and percutaneous coronary intervention (PCI). BACKGROUND: Statins may exert renal-protective effects through their pleiotropic properties. However, there have been conflicting reports on the CI-AKI preventive effect of pre-procedural statin administration. METHODS: Randomized controlled trials published between January 1st, 2003 and February 28th, 2014 comparing the preventive effects against CI-AKI of pre-procedural statins vs. control (lower statin dose, no statin, or placebo) in patients undergoing CA/PCI were included. RESULTS: Data were combined from 9 clinical trials enrolling 5212 patients (age 65 ± 5 years, 63% males). Pooled analysis showed that intensive, short-term statin pre-treatment significantly reduced the risk of CI-AKI as compared to control (relative risk [RR] 0.50; 95% confidence interval [CI] 0.39 to 0.64; P<0.001). Pre-specified subgroup analysis showed that intensive statin pre-treatment significantly reduced CI-AKI risk in patients with ACS (RR 0.37; 95% CI 0.25 to 0.55; P<0.0001), with only a non-significant positive trend in patients without ACS (RR 0.65; 95% CI 0.41 to 1.03; P=0.07). No evidence of publication bias was detected. CONCLUSIONS: Short-term, pre-procedural, intensive statin treatment significantly reduced CI-AKI incidence in ACS patients, and may contribute to the overall clinical benefit associated with the early use of these drugs in this clinical setting. Its role in non-ACS patients warrants further investigation.
OBJECTIVES: We assessed whether short-term, pre-procedural, intensive statin treatment may reduce contrast-induced acute kidney injury (CI-AKI) incidence in patients with and without acute coronary syndromes (ACS) undergoing coronary angiography (CA) and percutaneous coronary intervention (PCI). BACKGROUND: Statins may exert renal-protective effects through their pleiotropic properties. However, there have been conflicting reports on the CI-AKI preventive effect of pre-procedural statin administration. METHODS: Randomized controlled trials published between January 1st, 2003 and February 28th, 2014 comparing the preventive effects against CI-AKI of pre-procedural statins vs. control (lower statin dose, no statin, or placebo) in patients undergoing CA/PCI were included. RESULTS: Data were combined from 9 clinical trials enrolling 5212 patients (age 65 ± 5 years, 63% males). Pooled analysis showed that intensive, short-term statin pre-treatment significantly reduced the risk of CI-AKI as compared to control (relative risk [RR] 0.50; 95% confidence interval [CI] 0.39 to 0.64; P<0.001). Pre-specified subgroup analysis showed that intensive statin pre-treatment significantly reduced CI-AKI risk in patients with ACS (RR 0.37; 95% CI 0.25 to 0.55; P<0.0001), with only a non-significant positive trend in patients without ACS (RR 0.65; 95% CI 0.41 to 1.03; P=0.07). No evidence of publication bias was detected. CONCLUSIONS: Short-term, pre-procedural, intensive statin treatment significantly reduced CI-AKI incidence in ACS patients, and may contribute to the overall clinical benefit associated with the early use of these drugs in this clinical setting. Its role in non-ACS patients warrants further investigation.
Authors: Michael Robert Marchick; Brandon Russell Allen; Emily Cassin Weeks; Jonathan Jacob Shuster; Marie-Carmelle Elie Journal: Intern Emerg Med Date: 2016-02-24 Impact factor: 3.397
Authors: An Verdoodt; Patrick M Honore; Rita Jacobs; Elisabeth De Waele; Viola Van Gorp; Jouke De Regt; Herbert D Spapen Journal: J Transl Int Med Date: 2018-03-28
Authors: Maciej Banach; Manfredi Rizzo; Peter P Toth; Michel Farnier; Michael H Davidson; Khalid Al-Rasadi; Wilbert S Aronow; Vasilis Athyros; Dragan M Djuric; Marat V Ezhov; Robert S Greenfield; G Kees Hovingh; Karam Kostner; Corina Serban; Daniel Lighezan; Zlatko Fras; Patrick M Moriarty; Paul Muntner; Assen Goudev; Richard Ceska; Stephen J Nicholls; Marlena Broncel; Dragana Nikolic; Daniel Pella; Raman Puri; Jacek Rysz; Nathan D Wong; Laszlo Bajnok; Steven R Jones; Kausik K Ray; Dimitri P Mikhailidis Journal: Arch Med Sci Date: 2015-03-14 Impact factor: 3.318
Authors: M Joannidis; W Druml; L G Forni; A B J Groeneveld; P M Honore; E Hoste; M Ostermann; H M Oudemans-van Straaten; M Schetz Journal: Intensive Care Med Date: 2017-06-02 Impact factor: 17.440