Amirhossein Sahebkar1, Ivan Pećin2, Eugenia Tedeschi-Reiner3, Giuseppe Derosa4, Pamela Maffioli5, Željko Reiner6. 1. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. 2. University Hospital Center Zagreb, Department of Internal Medicine, Kišpatićeva 12, Zagreb, Croatia. 3. University Hospital Center Sestre Milosrdnice, University of Osijek, Vinogradska cesta 29, 10000 Zagreb, Croatia. 4. Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy; Molecular Medicine Laboratory, University of Pavia, Pavia, Italy. 5. Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; PhD School in Experimental Medicine, University of Pavia, Pavia, Italy. 6. University Hospital Center Zagreb, Department of Internal Medicine, Kišpatićeva 12, Zagreb, Croatia. Electronic address: zreiner@kbc-zagreb.hr.
Abstract
OBJECTIVE: To evaluate the effects of statin therapy on augmentation index (AIx) as a measure of arterial stiffness using a meta-analysis of clinical trials. METHODS: The search included PubMed-Medline, Embase, SCOPUS, Web of Science and Google Scholar databases to identify randomized controlled trials investigating the effects of statin therapy on arterial stiffness measured as AIx. A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Random-effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential confounders. RESULTS: 18 trials examining the effects of statin therapy on arterial stiffness were included. A significant reduction in aortic AIx following statin therapy was proven (WMD: -2.40%, 95% CI: -4.59, -0.21, p=0.032; I(2): 51.20%). HR-adjusted AIx 75% values also revealed a significant improvement by statin therapy (WMD: -5.04%, 95% CI: -7.81, -2.27, p<0.001; I(2): 0%), but not when analysis was restricted to unadjusted AIx values (WMD: -2.30%, 95% CI: -4.83, 0.23, p=0.075; I(2): 53.83%). There was no significant change in carotid (WMD: -2.75%, 95% CI: -8.06, 2.56, p=0.309; I(2): 26.86%) and peripheral (WMD: 0.25%, 95% CI: -3.31, 3.82, p=0.889; I(2): 72.19%) AIx due to statin treatment. There was also no difference in the effect size calculated for different statins subgroups. The impact of statins on AIx was independent of LDL-cholesterol level (slope: 0.05; 95% CI: -0.02, 0.13; p=0.181). CONCLUSION: Statin therapy causes a significant reduction in aortic AIx which is independent of LDL-cholesterol changes.
OBJECTIVE: To evaluate the effects of statin therapy on augmentation index (AIx) as a measure of arterial stiffness using a meta-analysis of clinical trials. METHODS: The search included PubMed-Medline, Embase, SCOPUS, Web of Science and Google Scholar databases to identify randomized controlled trials investigating the effects of statin therapy on arterial stiffness measured as AIx. A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Random-effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential confounders. RESULTS: 18 trials examining the effects of statin therapy on arterial stiffness were included. A significant reduction in aortic AIx following statin therapy was proven (WMD: -2.40%, 95% CI: -4.59, -0.21, p=0.032; I(2): 51.20%). HR-adjusted AIx 75% values also revealed a significant improvement by statin therapy (WMD: -5.04%, 95% CI: -7.81, -2.27, p<0.001; I(2): 0%), but not when analysis was restricted to unadjusted AIx values (WMD: -2.30%, 95% CI: -4.83, 0.23, p=0.075; I(2): 53.83%). There was no significant change in carotid (WMD: -2.75%, 95% CI: -8.06, 2.56, p=0.309; I(2): 26.86%) and peripheral (WMD: 0.25%, 95% CI: -3.31, 3.82, p=0.889; I(2): 72.19%) AIx due to statin treatment. There was also no difference in the effect size calculated for different statins subgroups. The impact of statins on AIx was independent of LDL-cholesterol level (slope: 0.05; 95% CI: -0.02, 0.13; p=0.181). CONCLUSION: Statin therapy causes a significant reduction in aortic AIx which is independent of LDL-cholesterol changes.
Authors: Chukwudiebube N Ajaero; Cher-Rin Chong; Nathan E K Procter; Saifei Liu; Yuliy Y Chirkov; Tamila Heresztyn; Wai Ping Alicia Chan; Margaret A Arstall; Andrew D McGavigan; Michael P Frenneaux; John D Horowitz Journal: ESC Heart Fail Date: 2017-10-13
Authors: Iuliia Pavlovska; Sarka Kunzova; Juraj Jakubik; Jana Hruskova; Maria Skladana; Irma Magaly Rivas-Serna; Jose R Medina-Inojosa; Francisco Lopez-Jimenez; Robert Vysoky; Yonas E Geda; Gorazd B Stokin; Juan P González-Rivas Journal: Lipids Health Dis Date: 2020-07-15 Impact factor: 3.876