Meta Analysis Of Intensive Atorvastatin In Prevention Of Contrast Induced Nephropathy Before Coronary Angiography/Percutaneous Coronary Intervention

Objective:With the development of coronary intervention,Contrast induced nephropathy is a common complication after coronary angiography(CAG)or percutaneous coronary intervention(PCI),Statins may reduce the risk of contrast induced nephropathy,But the existing research results show that the effect of atorvastatin in the prevention of CIN is still controversial,we will evaluate the clinical curative effect through the analysis of relevant data of large dose atorvastatin in prevention of CAG/PCI CIN after the operation,the relevant evidence to obtain directly the safety and efficacy of the CIN drugs in the prevention of postoperative patients in CAG/PCI.Methods:We searched Pub Med,EMBASE,Cochrane,Ovid,and Medline databases for all randomized controlled trials(random control trail,RCT)from January 1997 to July 2016.After strict evaluation of the quality of the literature,the data were extracted according to the requirements of RCT,and further analyzed by Meta.Results:8 clinical studies were included in our study,a total of 1269 patients,with the primary endpoint of the incidence of contrast induced nephropathy(CIN).The results showed that 627 cases of high dose atorvastatin treatment group and the happening of the CIN number 36 cases,incidence of 642 cases in the control group were 87 cases,high dose atorvastatin treatment group contrast the control group can significantly reduce the incidence of CIN(5.74 vs 13.55;RR=0.42;95%CI:0.29,0.61;P<0.001).Subgroup analysis,whether or not with N-acetylcysteine(NAG),short-term high-dose atorvastatin group than the control group can reduce the incidence of CIN.Conclusion:CAG/PCI before 12h/2-3 days of high-dose atorvastatin treatment can reduce the incidence of CIN in patients with normal or mild to moderate renal insufficiency,and40-80 mg high-dose group compared with the dose group can significantly reduce the incidence of CIN.And the subgroup analysis showed that both the definition of CIN,whether the application of NAC can significantly benefit.