Periprocedural effects of statins on the incidence of contrast-induced acute kidney injury: A systematic review and trial sequential analysis

International Journal of Cardiology
Nelson WangKevin Phan

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a potential complication in coronary angiography (CAG) and percutaneous coronary interventions (PCI). Prior randomized controlled trials (RCTs) have suggested that statins may play a role in reducing rates of CI-AKI, however it is not clear how firm the current evidence is. The aim of this study was to conduct a meta-analysis and trial sequential analysis to determine the effects of statins in lowering CI-AKI rates in CAG and PCI. A systematic literature search was performed to include all RCTs comparing statins (treatment arm) versus low-dose statins or placebo (control arm) as pretreatment for CAG and/or PCI. A traditional meta-analysis and several subgroup analyses were conducted using traditional meta-analysis with relative risk (RR), trial sequential analysis, and meta-regression analysis. 14 RCTs met our inclusion criteria giving a total of 2992 statin treated (49.6%) and 3041 control patients (50.4%). There was a significant reduction in CI-AKI in the statin group compared to controls (3.7% vs 8.3%, RR, 0.46; p=<0.00001). Trial sequential analysis using a relative risk reduction threshold of 20%, power 80% and type 1 error of 5%, indicated that the evidence is firm. A grea...Continue Reading

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Citations

Jun 22, 2016·Intensive Care Medicine·Miet Schetz, Heleen Oudemans-Van Straaten
Apr 7, 2017·Seminars in Dialysis·Jehan Z BahrainwalaMichael R Rudnick
Nov 19, 2017·Current Vascular Pharmacology·Djodje RadakEsma R Isenovic
Oct 18, 2016·Current Opinion in Nephrology and Hypertension·Jill VanmassenhoveNorbert Lameire
May 29, 2018·Journal of Nephrology·Valentina PistolesiEnrico Fiaccadori
Mar 24, 2018·Current Treatment Options in Cardiovascular Medicine·Arash Ehteshami Afshar, Puja B Parikh
May 6, 2019·European Journal of Radiology·Anne-Laure FauconOlivier Clément

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