title: Statin use prior to angiography for the prevention of contrast-induced acute kidney injury: a meta-analysis of 19 randomised trials.
abstract: OBJECTIVE
  A systematic review and a meta-analysis were performed to define better the role of statin use prior to angiography in preventing contrast-induced acute kidney injury (CI-AKI).
  
  
  RESULTS
  MEDLINE, Embase, Cochrane Library, references from review articles, and conference proceedings were searched, with no language restriction, for randomised controlled trials (RCT) evaluating the use of statin therapy prior to angiography for the prevention of CI-AKI. Nineteen RCTs including 7,161 patients were identified. The pooled analysis demonstrated a significant reduction in the incidence of CI-AKI in patients treated with statin prior to invasive angiography when compared with control (RR 0.52; 95% CI: 0.40-0.67). Patients with chronic kidney disease stage 3 or worse were largely underrepresented in these trials, and statin therapy did not significantly reduce the risk of CI-AKI in the three studies which enrolled a patient population with a mean eGFR of <60 ml/min (RR 0.54; 95% CI: 0.2-1.42).
  
  
  CONCLUSIONS
  This meta-analysis suggests a potential benefit for statin use prior to angiography to reduce the incidence of CI-AKI. Additional research is needed to define better the benefits of statin therapy prior to angiography to prevent CI-AKI, especially in high-risk patients with chronic kidney disease who were largely underrepresented in the available trials.
authors.affiliation: Kaiser Permanente, Los Angeles, CA, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Thompson
authors.forename: Rabia
authors.initials: R
authors.lastname: Razi
authors.forename: Ming Sum
authors.initials: MS
authors.lastname: Lee
authors.forename: Albert
authors.initials: A
authors.lastname: Shen
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Swapnil
authors.initials: S
authors.lastname: Hiremath
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Somjot S
authors.initials: SS
authors.lastname: Brar
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D000596:Amino Acids / Q000627:therapeutic use*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D016032:Randomized Controlled Trials as Topic
chemical_list: D000596:Amino Acids; D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C013165:statine