Benefit of statin pretreatment in prevention of contrast-induced nephropathy in different adult patient population

Systematic review and meta-analysis

Nirmal Singh, Justin Z. Lee, Jennifer J. Huang, See Wei Low, Carol Howe, Anil Pandit, Prakash Suryanarayana, Kwan S Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: Previous studies have suggested that statin pretreatment prevents contrast-induced nephropathy (CIN). However, single randomised trials are limited in their number of patients. This meta-analysis aims to assess the role of statin use in CIN prevention, as well as to determine patient subgroups that will benefit from statin pre-treatment. Methodology: We searched PubMed, EMBASE, Web of science and the Cochrane Central Register of Controlled Trials databases for randomised controlled trials (RCT) comparing statin pretreatment versus placebo for preventing CIN. Our main outcome was the risk of CIN within 1-5 days after contrast administration. Results: Data analysed from nine randomised studies with a total of 5143 patients, where 2559 received statins and 2584 received placebo, showed that statin pretreatment was associated with significant reduction in risk of CIN (MH-RR=0.47, 95% CI 0.34 to 0.64, Z=4.49, p<0.00001). This beneficial effect of statin was also seen in patients with baseline renal impairment (MH-RR=0.46, 95% CI 0.29 to 0.72, p=0.0008) and also those who were cotreated with NAC (MH-RR=0.46, 95% CI 0.25 to 0.83, p=0.01). Conclusions: Statin pretreatment leads to significant reduction in CIN, and should be strongly considered in all patients who are planned for diagnostic and interventional procedures involving contrast-media administration.

Original languageEnglish (US)
Article numbere000127
JournalOpen Heart
Volume1
Issue number1
DOIs
StatePublished - 2014

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Meta-Analysis
Population
Placebos
Risk Reduction Behavior
PubMed
Contrast Media
Randomized Controlled Trials
Databases
Kidney

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Benefit of statin pretreatment in prevention of contrast-induced nephropathy in different adult patient population : Systematic review and meta-analysis. / Singh, Nirmal; Lee, Justin Z.; Huang, Jennifer J.; Low, See Wei; Howe, Carol; Pandit, Anil; Suryanarayana, Prakash; Lee, Kwan S.

In: Open Heart, Vol. 1, No. 1, e000127, 2014.

Research output: Contribution to journalArticle

Singh, Nirmal ; Lee, Justin Z. ; Huang, Jennifer J. ; Low, See Wei ; Howe, Carol ; Pandit, Anil ; Suryanarayana, Prakash ; Lee, Kwan S. / Benefit of statin pretreatment in prevention of contrast-induced nephropathy in different adult patient population : Systematic review and meta-analysis. In: Open Heart. 2014 ; Vol. 1, No. 1.
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abstract = "Objective: Previous studies have suggested that statin pretreatment prevents contrast-induced nephropathy (CIN). However, single randomised trials are limited in their number of patients. This meta-analysis aims to assess the role of statin use in CIN prevention, as well as to determine patient subgroups that will benefit from statin pre-treatment. Methodology: We searched PubMed, EMBASE, Web of science and the Cochrane Central Register of Controlled Trials databases for randomised controlled trials (RCT) comparing statin pretreatment versus placebo for preventing CIN. Our main outcome was the risk of CIN within 1-5 days after contrast administration. Results: Data analysed from nine randomised studies with a total of 5143 patients, where 2559 received statins and 2584 received placebo, showed that statin pretreatment was associated with significant reduction in risk of CIN (MH-RR=0.47, 95{\%} CI 0.34 to 0.64, Z=4.49, p<0.00001). This beneficial effect of statin was also seen in patients with baseline renal impairment (MH-RR=0.46, 95{\%} CI 0.29 to 0.72, p=0.0008) and also those who were cotreated with NAC (MH-RR=0.46, 95{\%} CI 0.25 to 0.83, p=0.01). Conclusions: Statin pretreatment leads to significant reduction in CIN, and should be strongly considered in all patients who are planned for diagnostic and interventional procedures involving contrast-media administration.",
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AU - Howe, Carol

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N2 - Objective: Previous studies have suggested that statin pretreatment prevents contrast-induced nephropathy (CIN). However, single randomised trials are limited in their number of patients. This meta-analysis aims to assess the role of statin use in CIN prevention, as well as to determine patient subgroups that will benefit from statin pre-treatment. Methodology: We searched PubMed, EMBASE, Web of science and the Cochrane Central Register of Controlled Trials databases for randomised controlled trials (RCT) comparing statin pretreatment versus placebo for preventing CIN. Our main outcome was the risk of CIN within 1-5 days after contrast administration. Results: Data analysed from nine randomised studies with a total of 5143 patients, where 2559 received statins and 2584 received placebo, showed that statin pretreatment was associated with significant reduction in risk of CIN (MH-RR=0.47, 95% CI 0.34 to 0.64, Z=4.49, p<0.00001). This beneficial effect of statin was also seen in patients with baseline renal impairment (MH-RR=0.46, 95% CI 0.29 to 0.72, p=0.0008) and also those who were cotreated with NAC (MH-RR=0.46, 95% CI 0.25 to 0.83, p=0.01). Conclusions: Statin pretreatment leads to significant reduction in CIN, and should be strongly considered in all patients who are planned for diagnostic and interventional procedures involving contrast-media administration.

AB - Objective: Previous studies have suggested that statin pretreatment prevents contrast-induced nephropathy (CIN). However, single randomised trials are limited in their number of patients. This meta-analysis aims to assess the role of statin use in CIN prevention, as well as to determine patient subgroups that will benefit from statin pre-treatment. Methodology: We searched PubMed, EMBASE, Web of science and the Cochrane Central Register of Controlled Trials databases for randomised controlled trials (RCT) comparing statin pretreatment versus placebo for preventing CIN. Our main outcome was the risk of CIN within 1-5 days after contrast administration. Results: Data analysed from nine randomised studies with a total of 5143 patients, where 2559 received statins and 2584 received placebo, showed that statin pretreatment was associated with significant reduction in risk of CIN (MH-RR=0.47, 95% CI 0.34 to 0.64, Z=4.49, p<0.00001). This beneficial effect of statin was also seen in patients with baseline renal impairment (MH-RR=0.46, 95% CI 0.29 to 0.72, p=0.0008) and also those who were cotreated with NAC (MH-RR=0.46, 95% CI 0.25 to 0.83, p=0.01). Conclusions: Statin pretreatment leads to significant reduction in CIN, and should be strongly considered in all patients who are planned for diagnostic and interventional procedures involving contrast-media administration.

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