Journal article
Meta-analysis on efficacy of statins for prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography
The American journal of cardiology, v 114(9), pp 1295-1302
01 Nov 2014
PMID: 25239829
Abstract
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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Details
- Title
- Meta-analysis on efficacy of statins for prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography
- Creators
- Anene Ukaigwe - Reading HospitalParas Karmacharya - Reading HospitalMaryam Mahmood - Reading HospitalRanjan Pathak - Reading HospitalMadan Raj Aryal - Reading HospitalLeena Jalota - Reading HospitalAnthony A Donato - Reading Hospital
- Publication Details
- The American journal of cardiology, v 114(9), pp 1295-1302
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Web of Science ID
- WOS:000343960000002
- Scopus ID
- 2-s2.0-84908066776
- Other Identifier
- 991022161834804721