Cheng Bin1, Mu Junsheng2, Zhang Jianqun1, Bo Ping1. 1. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 2. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: wesleymu@hotmail.com.
Abstract
BACKGROUND: The aim of this study was to evaluate the medium- and long-term efficacy of loading statins after coronary artery bypass grafting (CABG) by comparing using a loading dose of statins or a regular dose of statins in patients undergoing CABG. METHODS: We conducted a literature search of numerous databases for randomized controlled trials on the efficacy of a loading dose of statins in patients undergoing CABG. The quality of included studies was evaluated according to the Newcastle-Ottawa Scale. Statistical results of treatment were represented by weighted mean difference, odds ratio, and 95% confidence interval. RESULTS: There were 8 studies including 8,676 patients (4,352 who had a loading dose of statins and 4,324 who had a regular dose). Meta-analysis showed statistically significant differences in the following in patients who took a loading dose of statins: lower level of low-density lipoprotein cholesterol (LDL-C) after CABG (p < 0.00001), fewer deaths caused by myocardial infarction (p = 0.005), fewer patients with myocardial infarction (p = 0.004), fewer patients undergoing secondary CABG (p < 0.00001), and fewer patients undergoing graft restenosis by intravascular ultrasonography (p < 0.0001). CONCLUSIONS: Comparing patients receiving a loading dose of statins with those receiving a regular dose after CABG, the medium- and long-term efficacy of a loading dose showed significant reduction in LDL-C, lower occurrence of adverse cardiac events, and reduction in graft restenosis. Although the incidence of drug-related side effects was slightly higher in the loading-dose group, in the majority of patients they were not serious. Overall, a loading dose of statins is superior to regular dosing of statins after CABG.
BACKGROUND: The aim of this study was to evaluate the medium- and long-term efficacy of loading statins after coronary artery bypass grafting (CABG) by comparing using a loading dose of statins or a regular dose of statins in patients undergoing CABG. METHODS: We conducted a literature search of numerous databases for randomized controlled trials on the efficacy of a loading dose of statins in patients undergoing CABG. The quality of included studies was evaluated according to the Newcastle-Ottawa Scale. Statistical results of treatment were represented by weighted mean difference, odds ratio, and 95% confidence interval. RESULTS: There were 8 studies including 8,676 patients (4,352 who had a loading dose of statins and 4,324 who had a regular dose). Meta-analysis showed statistically significant differences in the following in patients who took a loading dose of statins: lower level of low-density lipoprotein cholesterol (LDL-C) after CABG (p < 0.00001), fewer deaths caused by myocardial infarction (p = 0.005), fewer patients with myocardial infarction (p = 0.004), fewer patients undergoing secondary CABG (p < 0.00001), and fewer patients undergoing graft restenosis by intravascular ultrasonography (p < 0.0001). CONCLUSIONS: Comparing patients receiving a loading dose of statins with those receiving a regular dose after CABG, the medium- and long-term efficacy of a loading dose showed significant reduction in LDL-C, lower occurrence of adverse cardiac events, and reduction in graft restenosis. Although the incidence of drug-related side effects was slightly higher in the loading-dose group, in the majority of patients they were not serious. Overall, a loading dose of statins is superior to regular dosing of statins after CABG.