title: Preoperative Statin Therapy and Renal Outcomes After Cardiac Surgery: A Meta-analysis and Meta-regression of 59,771 Patients.
abstract: BACKGROUND
  The purpose of this study was to investigate the effects of preoperative statin therapy (PST) on short- and long-term renal dysfunction after cardiac surgery.
  
  
  METHODS
  We searched for reports that investigated the effects of PST on renal outcomes after cardiac surgery in the electronic literature databases PubMed, Ovid, and Elsevier.
  
  
  RESULTS
  Twenty-six reports including 59,771 patients were selected for meta-analysis. The meta-analysis revealed that PST significantly reduced the incidence of postoperative renal dysfunction (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.95; P < 0.0001) without significant heterogeneity (I(2) = 28.1%; P = 0.093). PST also significantly reduced the need for postoperative renal replacement therapy (OR = 0.76; 95% CI, 0.62-0.92; z = 2.77; P = 0.006); particularly in the subgroup of patients who underwent isolated coronary artery bypass grafting, the rate of renal replacement therapy was reduced by 56% (OR, 0.44; 95% CI, 0.30-0.66; z = 4.08; P < 0.0001) with low heterogeneity (I(2) = 18.7%; P = 0.297). Meta-analysis for the outcome of acute kidney injury (AKI) revealed that PST reduced the incidence of postoperative AKI by 13% (OR, 0.87; 95% CI, 0.80-0.94; P = 0.001) and 7% (OR, 0.93; 95% CI, 0.86-0.99; P = 0.031), respectively, for subgroups of patients whose AKI was evaluated using the Acute Kidney Injury Network (AKIN) or the Risk, Injury, Failure, Loss, and End Stage (RIFLE) criteria, without significant heterogeneity for either.
  
  
  CONCLUSIONS
  PST might be a promising therapy to reduce renal complications after cardiac surgery although large-scaled randomized controlled trials are needed to further verify the conclusion.
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Jiayang
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Chengxiong
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Mingxin
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China. Electronic address: heartyuyang@hotmail.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors