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Meta-analysis on efficacy of statins for prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography
Journal article   Peer reviewed

Meta-analysis on efficacy of statins for prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography

Anene Ukaigwe, Paras Karmacharya, Maryam Mahmood, Ranjan Pathak, Madan Raj Aryal, Leena Jalota and Anthony A Donato
The American journal of cardiology, v 114(9), pp 1295-1302
01 Nov 2014
DOI: https://doi.org/10.1016/j.amjcard.2014.07.059
PMID: 25239829
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Acute Kidney Injury - chemically induced Acute Kidney Injury - prevention & control Contrast Media - adverse effects Coronary Angiography - adverse effects Coronary Artery Disease - diagnostic imaging Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Treatment Outcome
Contrast-induced acute kidney injury (CIAKI) is a leading cause of hospital-acquired acute kidney injury, and pretreatment with hydroxymethylglutaryl CoA reductase inhibitors (statins) have shown promise in prevention. A systematic review and meta-analysis was performed including randomized controlled trials of short-term high-dose statins (compared with either low-dose statin or placebo) for CIAKI prevention in patients undergoing coronary angiography. Study-specific odds ratios (ORs) were calculated, and between-study heterogeneity was assessed using the I(2) statistic. We used a random-effects model meta-analysis to pool the OR. Twelve RCTs, including 5,564 patients, were included. CIAKI occurred in 94 of 2,769 patients (3.4%) pretreated with high-dose statins and 213 of 2,795 patients (7.6%) in the low-dose or no-statin group (OR 0.43, 95% confidence interval [CI] 0.33 to 0.55, I(2) = 19%, p <0.001). Subgroup analysis showed that the occurrence of CIAKI did not differ in patients with diabetes (OR 0.60, 95% CI 0.43 to 0.85, I(2) = 0%, p = 0.004) or in patients with documented renal insufficiency (creatinine clearance <60 ml/min/m(2); OR 0.66, 95% CI 0.45 to 0.96, I(2) = 0%, p = 0.03). In conclusion, pretreatment with high-dose statins, compared with low-dose statins or placebo, in patients undergoing coronary angiography reduces the incidence of CIAKI. This benefit was seen irrespective of the presence of diabetes and chronic kidney disease. Future studies should identify optimum dosing protocols for each statin.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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