| Objective: To evaluate the efficacy of high-dose statins in patients with ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods: PubMed,SinoMed,EMBASE,the Cochrane Library,CNKI and relevant magazines were reviewed for randomized controlled trials(RCTs)published up to March 25,2017.Two authors independently collected relevant literature,extracted basic information and end point events according to a designed table,evaluated the quality and checked with each other to ensure consistency of the included trials.Final meta-analyses and risk of biases were performed by RevMan 5.3 software.We did qualitative evaluation of publication bias using funnel plot and quantitative evaluation according to Egger?s test using Stata 12.0 software.Results: We identified 527 relevant articles.Of these 84 articles were found to be duplicates and were excluded.After screening the titles and abstracts,we reviewed the full text of 28 articles.Finally,eleven RCTsinvolving 1419 patients were included.The results of risk of biases showed that about 64 percent of the studies used random sequence generation.The results showed that high-dose statins significantly improved the final thrombolysis in myocardial infarction(TIMI)flow grade after PCI(risk ratio [RR]= 1.09;95% confidence interval [CI]: 1.05~1.13,P <0.01)and reduced the incidence of major adverse events(MACEs)at 30-day follow up(RR = 0.50;95%CI 0.32~0.79,P <0.01).Subgroup analysis indicated that only short-term high-dose statin(RR = 0.52;95%CI 0.30~0.91,P <0.05)but not single high-dose statin treatment(RR = 0.47;95%CI 0.22 ~ 1.01,P = 0.05)showed priority in decreasing the occurrence of MACEs.The results of funnel plot and Egger?s test showed that no publication biases were observed(P = 0.371,P = 0.312,respectively).Conclusion: High-dose statins can significantly improve microvascular myocardial perfusion and decrease the incidence of 30-day MACEs in STEMI patients post-PCI. |
PDF Full Text Request