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Effect of statin therapy on contrast-induced nephropathy after coronary angiography: A meta-analysis
International Journal of Cardiology, 09/12/2011
Evidence Based Medicine
Clinical Article
Pappy R et al. – This meta–analysis suggests that statin therapy might be associated with a significant reduction in the incidence of contrast–induced nephropathy (CIN) in patients undergoing coronary angiography. Further studies are warranted to clarify this issue.
Methods- Authors searched MEDLINE and EMBASE databases through December 2010 for articles evaluating the effect of statins on the incidence of CIN in patients undergoing coronary angiography.
- Odds ratios (OR) with 95% confidence intervals (CI) were calculated using random effects modeling.
- Three randomized controlled trials involving 770 patients (330 in the statin group and 340 in the control group) and 7 non–randomized studies involving 31,959 patients (11,936 statin–pretreated and 20,023 statin–naïve).
- The definition of CIN varied somewhat among the studies.
- Based on the pooled estimate across the 3 randomized controlled trials, statin therapy did not significantly reduce the incidence of CIN compared to control (OR=0.76, 95% CI: 0.41–1.41, p=0.39).
- No significant heterogeneity was found in the randomized studies (I2=0%, p=0.48)
- The pooled analysis of the non–randomized studies showed a marginally significant benefit associated with statin therapy (OR=0.60, 95% CI: 0.36–1.00, p=0.05).
- There was significant heterogeneity among the non–randomized studies (I2=88%, p<0.00001).