Abstract 14725: Comparative Efficacy of Pre-procedural Statins in Preventing Contrast-induced Nephropathy: A Network Meta-analysis
Introduction: Contrast-induced nephropathy (CIN) is an important adverse outcome of coronary angiography/intervention. The role of pre-procedural statins in preventing CIN is unclear. Furthermore, the relative efficacy of different statins is unknown. Accordingly, we sought to perform a network meta-analysis to address this question.
Methods: We performed a Bayesian network meta-analysis of randomized controlled trials that evaluated the impact of statin therapy prior to coronary angiography/intervention on post-procedure outcomes. The primary outcome was the incidence of CIN assessed as an increase in serum creatinine >0.5 mg/dl or > 25% from baseline at 48-72 hours; need for hemodialysis (HD) at 30 days was the secondary outcome. Different types and doses of statins were pooled and compared with Bayesian random-effects models, calculating pooled odds ratios (OR) and associated 95% credible intervals (95% CrI) for the Bayesian analysis.
Results: A total of 14 studies (9 statin vs. placebo; 5 high-dose vs. low dose statin; 9 atorvastatin; 4 rosuvastatin; 2 simvastatin) enrolling a total of 5,927 patients were included in the analysis. High-dose statin therapy was associated with lower risk of CIN compared with placebo/low dose statin (OR = 0.5; 95% CrI 0.4-0.7). Among different statins, high dose atorvastatin was associated with the lowest risk of CIN (Table). High dose statin therapy was associated with a numerically lower incidence of need for HD compared with placebo (OR = 0.25; 95% CrI 0.05-1.20), with minor differences observed among the different statins.
Conclusion: Pre-procedure statin therapy is associated with a lower risk of CIN following coronary angiography/intervention, with high dose atorvastatin having the highest efficacy. It should be considered in all patients undergoing these procedures, especially in those who are high-risk for post-procedure CIN.
Author Disclosures: A. Pandey: None. B. Aggarwal: None. S. Chatterjee: None. P. Mody: None. H. Jneid: None. S. Banerjee: None. E. Birlakis: None. A. Bavry: None. J. Giri: None. S. Das: None. J. De Lemos: None. D. Kumbhani: None.
- © 2014 by American Heart Association, Inc.