Intensive vs non-intensive statin pretreatment before percutaneous coronary intervention in Chinese patients:A meta-analysis of randomized controlled trials  

作　　者：Xian Yang Xi Lan Xin-Lin Zhang Zhong-Lin Han Si-Min Yan Wen-Xiao Wang Biao Xu Wei-Hong Ge 

机构地区：[1]Department of Pharmacy,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,Jiangsu Province,China [2]Department of Pharmacy,Nanjing Medical Center for Clinical Pharmacy,Nanjing 210000,Jiangsu Province,China [3]Department of Cardiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,Jiangsu Province,China [4]Department of Pharmacy,The Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2022年第5期1557-1571,共15页世界临床病例杂志

基　　金：Supported by the Scientific Research Project of Nanjing Clinical Medical Centre,No.1 Ning Health Science Education[2020].

摘　　要：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 byχ2 test and I2 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,P<0.00001).However,compared with the patients receiving moderateintensity statin before surgery,no advantage to intensive statin treatment was seen(RR=1.04,95%CI:0.82-1.31,P=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,P=0.06),myalgia/myasthenia(RR=1.35,95%CI:0.30-5.95,P=0.69)and abnormal alanine aminotransferase(RR=1.47,95%CI:0.54-4.02,P=0.45)except non-fatal MI(RR=0.54,95%CI:0.33-0.88,P=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

关 键 词：INTENSIVE Non-intensive STATIN Percutaneous coronary intervention Chinese META-ANALYSIS 

分 类 号：R541.4[医药卫生—心血管疾病]