AI Article Synopsis
- - The study analyzed the effects of high-dose statin pretreatment before percutaneous coronary intervention (PCI) in Chinese patients by reviewing eleven studies with 3,123 participants to assess major cardiovascular outcomes.
- - Results indicated a significant reduction in major adverse cardiovascular events (MACE) with intensive statin use compared to placebo, but no significant benefits over moderate-intensity statin therapy or other outcomes like target vessel revascularization and muscle symptoms.
- - The findings suggest intensive statin therapy reduces risk for non-fatal myocardial infarction but does not show additional advantages over moderate therapy for other complications, highlighting a need for more tailored treatment approaches.
Article Abstract
Background: The results of intensive statin pretreatment before percutaneous coronary intervention (PCI) is inconsistent between Chinese and Western populations, and there are no corresponding meta-analyses involving hard clinical endpoints in the available published literature.
Aim: To evaluate the efficacy and safety of high-dose statin loading before PCI in Chinese patients through a meta-analysis.
Methods: Relevant studies were identified by searching the electronic databases of PubMed, Embase and Cochrane's Library to December 2019. The outcomes included an assessment of major adverse cardiovascular event (MACE), non-fatal myocardial infarction (MI), cardiac death, target vessel revascularization (TVR), myalgia /myasthenia and abnormal alanine aminotransferase (ALT) in all enrolled patients. Random effect model and fixed effect model were applied to combine the data, which were further analyzed by test and test. The main outcomes were then analyzed through the use of relative risks (RR) and its 95% confidence interval (95%CI).
Results: Eleven studies involving 3123 individuals were included. Compared with patients receiving placebo or no statin treatment before surgery, intensive statin treatment was associated with a clear reduction of risk of MACE (RR = 0.44, 95%CI: 0.31-0.61, < 0.00001). However, compared with the patients receiving moderate-intensity statin before surgery, no advantage to intensive statin treatment was seen (RR = 1.04, 95%CI: 0.82-1.31, = 0.74). In addition, no significant difference was observed between intensive statin therapy and non-intensive statin therapy on the incidence of TVR (RR = 0.43, 95%CI: 0.18-1.02, = 0.06) , myalgia /myasthenia (RR = 1.35, 95%CI: 0.30-5.95, = 0.69) and abnormal alanine aminotransferase (RR = 1.47, 95%CI: 0.54-4.02, = 0.45) except non-fatal MI (RR = 0.54, 95%CI: 0.33-0.88, = 0.01).
Conclusion: Compared with placebo or no statin pretreatment, intensive statin before PCI displayed reduced incidence of MACE. However, there was no significant benefit between high and moderate-intensity statin. In addition, no significant difference was observed between intensive statin therapy and non-intensive statin therapy on the incidence of TVR, myalgia/myasthenia and abnormal alanine aminotransferase except non-fatal MI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8855259 | PMC |
| http://dx.doi.org/10.12998/wjcc.v10.i5.1557 | DOI Listing |
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