title: Effects of statin therapy on augmentation index as a measure of arterial stiffness: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the effects of statin therapy on augmentation index (AIx) as a measure of arterial stiffness using a meta-analysis of clinical trials.
  
  
  METHODS
  The search included PubMed-Medline, Embase, SCOPUS, Web of Science and Google Scholar databases to identify randomized controlled trials investigating the effects of statin therapy on arterial stiffness measured as AIx. A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Random-effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential confounders.
  
  
  RESULTS
  18 trials examining the effects of statin therapy on arterial stiffness were included. A significant reduction in aortic AIx following statin therapy was proven (WMD: -2.40%, 95% CI: -4.59, -0.21, p=0.032; I(2): 51.20%). HR-adjusted AIx 75% values also revealed a significant improvement by statin therapy (WMD: -5.04%, 95% CI: -7.81, -2.27, p<0.001; I(2): 0%), but not when analysis was restricted to unadjusted AIx values (WMD: -2.30%, 95% CI: -4.83, 0.23, p=0.075; I(2): 53.83%). There was no significant change in carotid (WMD: -2.75%, 95% CI: -8.06, 2.56, p=0.309; I(2): 26.86%) and peripheral (WMD: 0.25%, 95% CI: -3.31, 3.82, p=0.889; I(2): 72.19%) AIx due to statin treatment. There was also no difference in the effect size calculated for different statins subgroups. The impact of statins on AIx was independent of LDL-cholesterol level (slope: 0.05; 95% CI: -0.02, 0.13; p=0.181).
  
  
  CONCLUSIONS
  Statin therapy causes a significant reduction in aortic AIx which is independent of LDL-cholesterol changes.
authors.affiliation: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
authors.affiliation: University Hospital Center Zagreb, Department of Internal Medicine, Kišpatićeva 12, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Pećin
authors.affiliation: University Hospital Center Sestre Milosrdnice, University of Osijek, Vinogradska cesta 29, 10000 Zagreb, Croatia.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Tedeschi-Reiner
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy; Molecular Medicine Laboratory, University of Pavia, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy; PhD School in Experimental Medicine, University of Pavia, Pavia, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Maffioli
authors.affiliation: University Hospital Center Zagreb, Department of Internal Medicine, Kišpatićeva 12, Zagreb, Croatia. Electronic address: zreiner@kbc-zagreb.hr.
authors.forename: Željko
authors.initials: Ž
authors.lastname: Reiner
mesh_terms: D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D016013:Likelihood Functions; D008297:Male; D016032:Randomized Controlled Trials as Topic; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors