Meta-Analysis Of The Studies Assessing Short-term High-dose Statin For The Prevention Of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention

Purpose:As the intervention technology has developed rapidly in recent years,the use of contains iodine contrast agent in radioactive intervention operation has also been increasing, and CIN has become one of the three main reasons of the in-hospital acute kidney injury in the world. Therefore. the exploration and research of CIN drug prevention measures has become an urgent issue. Among the drugs, statins has also been studied in many published clinical trials, and the current results about the preventive effect of statins to CIN are variable. This meta-analysis aims to assess the effect of short-term high-dose statins for the prevention of CIN in patients undergoing PCI by gathering the ralated clinical research which used the value of SCr as basic evaluation.Method:Eligible studies on PubMed、Embase、Cochrane databases were searched and then analyzed through Review Manager5. The primary terminal point was the morbidity of CIN. RR was used to evaluate the results (dichotomous variables). Heterogeneity of the studies was analyzed by Cochran’s Q statistics. Sensitivity of the studies was analyzed by stratified analysis according to the nation and statins. All of biases of the studies were analyzed by funnel plot.Results:This meta-analysis adopted seven studies from seven papers. The total number of patients was1382.Found a beneficial effect in short-term high-dose statins for the prevention of contrast-induced nephropathy(rate ratio0.47,95%CI [0.32,0.69] P<0.0001), with no significant heterogeneity across studies(P=0.24).Migration risk analysis into all studies, inverted funnel shaped funnel graph, roughly symmetrical on both sides, this meta analysis had no publication bias.Stratified analysis:Jadad score less-than five had no statistically significant.and five points subgroup showed a low RR(0.34).people in East Asia (RR0.32,95%CI [0.18,0.57], P=0.0001) preceded European (RR0.67,95%CI [0.40,1.13], P=0.13).Treatment with atorvastatin(RR0.51,95%CI [0.18,0.57], P=0.002) showed a lower RR than simvastatin(RR0.34,95%CI [0.14,0.82], P=0.02).Changes in estimated glomerular filtration rate from baseline to postprocedure versus control had improvement(WMD3.47mL/min,95%CI[0.53,6.4], P=0.02).Conclusion:The use of high-dose contrast medium is one of the main reasons of AKI and poor prognosis. Short-term high-dose statins is likely effective in prevention of CIN, and Asiatic had a more significant than European as the a same dose.