title: Efficacy of Short-Term Statin Treatment for the Prevention of Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography/Percutaneous Coronary Intervention: A Meta-Analysis of 21 Randomized Controlled Trials.
abstract: BACKGROUND
  The results of previous studies have been contradictory in terms of the efficacy of statin treatment in preventing contrast-induced acute kidney injury (CI-AKI) and clinical adverse events (AEs).
  
  
  OBJECTIVE
  This meta-analysis was undertaken to assess the role of short-term statin treatment in the prevention of CI-AKI and clinical AEs.
  
  
  METHODS
  We searched the Cochrane Library, EMBASE, and PubMed databases for randomized controlled trials (RCTs) with the development of CI-AKI as a primary outcome. Secondary outcomes were the post-procedural serum creatinine (SCr) level, estimated glomerular filtration rate (eGFR), and development of AEs. We also performed prespecified subgroup analyses.
  
  
  RESULTS
  A total of 21 RCTs involving 7746 patients were included. Short-term statin treatment significantly reduced the risk of CI-AKI [risk ratio (RR) 0.57; 95 % confident interval (CI) 0.47-0.69; p < 0.00001) and was associated with a lower post-procedural SCr level and a higher eGFR. High-dose statins resulted in a lower incidence of CI-AKI than the lower-dose statins. In addition, the benefit was seen across various subgroups for patients at risk of CI-AKI, statin-naïve patients, and East Asians, regardless of statin type, definition of CI-AKI, use of N-acetylcysteine (NAC) and hydration, and osmolality of contrast. However, there was no significant difference between the two groups in terms of the incidence of AEs.
  
  
  CONCLUSIONS
  The meta-analysis suggests that short-term statin treatment can effectively prevent CI-AKI, and the benefit is also observed in high-risk patients, statin-naïve patients, and an East Asian population. However, the effect of simvastatin for the prevention of CI-AKI, of statins for the prevention of AEs, and whether high-dose statins have a better effect than lower-dose statins are all still uncertain.
authors.affiliation: Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang, Liaoning, China.
authors.forename: Haixia
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Cardiology, General Hospital of Shenyang Military Area, Shenhe District, Shenyang, Liaoning, China.
authors.forename: Cailian
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Nephrology, General Hospital of Shenyang Military Area, Shenhe District, Shenyang, Liaoning, China.
authors.forename: Chuanzhi
authors.initials: C
authors.lastname: Liu
authors.affiliation: Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang, Liaoning, China.
authors.forename: Ruifei
authors.initials: R
authors.lastname: Li
authors.affiliation: Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang, Liaoning, China.
authors.forename: Meijuan
authors.initials: M
authors.lastname: Zou
authors.affiliation: Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang, Liaoning, China. chenggang63@hotmail.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Cheng
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors