Meta-analysis of short-term high versus low doses of atorvastatin preventing contrast-induced acute kidney injury in patients undergoing coronary angiography/percutaneous coronary intervention

J Clin Pharmacol. 2015 Feb;55(2):123-31. doi: 10.1002/jcph.411. Epub 2015 Jan 5.

Abstract

This study aimed to investigate the impact of different doses of atorvastatin on contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) requiring contrast media by performing a meta-analysis. We searched the PubMed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure, and VIP database through April 2014. Only randomized controlled trials (RCTs) comparing short-term high-dose atorvastatin with low-dose atorvastatin on CI-AKI were selected. The main outcomes were the change of acute kidney injury markers and the incidence of contrast-induced nephropathy (CIN). We combined 14 RCTs consisting of 1,689 patients. Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a reduction in serum creatinine levels (weighted mean differences [WMD]-0.1 mg/dL; 95%CI -0.14 to -0.05). In addition, high-dose atorvastatin treatment was also associated with a lower incidence of CIN (risk ratios 0.41; 95%CI 0.29-0.56). This meta-analysis suggests that short-term high-dose atorvastatin therapy appears to be superior to the low-dose atorvastatin in preventing CI-AKI among patients undergoing CAG/PCI requiring contrast media.

Keywords: atorvastatin; contrast-induced acute kidney injury; coronary angiography; meta-analysis; percutaneous coronary intervention.

Publication types

  • Meta-Analysis

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / prevention & control*
  • Aged
  • Atorvastatin
  • Contrast Media / adverse effects
  • Coronary Angiography
  • Creatinine / blood
  • Drug Administration Schedule
  • Female
  • Heptanoic Acids / administration & dosage*
  • Heptanoic Acids / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention
  • Pyrroles / administration & dosage*
  • Pyrroles / therapeutic use
  • Randomized Controlled Trials as Topic

Substances

  • Contrast Media
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Atorvastatin
  • Creatinine