Document Detail


Effect of statins pretreatment on periprocedural myocardial infarction in patients undergoing percutaneous coronary intervention: a meta-analysis.
MedLine Citation:
PMID:  20384433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Periprocedural myocardial injury remains the most common complication associated with percutaneous coronary intervention (PCI). Previous studies have demonstrated that even a small elevation of cardiac enzymes is associated with higher risk of mortality during follow-up. OBJECTIVE: We performed a meta-analysis based on all currently available randomized controlled trials (RCT) to evaluate the beneficial effects of hydroxymethylglutaryl-CoA reductase inhibitors (statins) given before PCI on preventing periprocedural myocardial infarction (MI). METHODS: The published literature was scanned by formal searches of electronic databases (PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) and conference proceedings up through August 2009. RCTs were eligible for inclusion if they compared preprocedural statins versus placebo treatment in patients not taking statins previously but scheduled for PCI and had the data of periprocedural MI reported by the trial investigators. RESULTS: Prespecified criteria were met by 6 RCTs involving 2,088 patients. During the periprocedural period, 81 of 1,051 patients (7.7%) in the statins pretreatment group developed periprocedural MI, significantly less than 147 of 1,037 (14.2%) patients assigned to the control group (OR 0.51, 95% CI 0.38-0.67; P< 0.001). During 1-month follow-up, only 4 deaths, 7 non-periprocedural Q-wave MIs, and 4 revascularizations occurred in all 2,088 enrolled patients. The composite of death, MI, or target vessel revascularization at 1 month, essentially driven by periprocedural MI, was reported in 8.0% in the statins pretreatment group and 15.3% in the control group (OR 0.48, 95% CI 0.36-0.64; P< 0.001). CONCLUSIONS: This meta-analysis supports the effectiveness of statins pretreatment on reducing the rate of periprocedural MI in patients undergoing PCI.
Authors:
Feng Zhang; Lili Dong; Junbo Ge
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of medicine     Volume:  42     ISSN:  1365-2060     ISO Abbreviation:  Ann. Med.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906388     Medline TA:  Ann Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  171-7     Citation Subset:  IM    
Affiliation:
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Coronary Artery Disease / drug therapy,  therapy
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Myocardial Infarction / prevention & control*
Randomized Controlled Trials as Topic
Research Design
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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