High-dose statin pretreatment decreases periprocedural myocardial infarction and cardiovascular events in patients undergoing elective percutaneous coronary intervention: a meta-analysis of twenty-four randomized controlled trials.
High-dose statin pretreatment decreases periprocedural myocardial infarction and cardiovascular events in patients undergoing elective percutaneous coronary intervention: a meta-analysis of twenty-four randomized controlled trials.
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高剂量他汀类药物预处理可减少接受择期经皮冠状动脉介入治疗的患者围手术期心肌梗死和心血管事件：对二十四项随机对照试验的荟萃分析。
DOI：
10.1371/journal.pone.0113352
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhou Y
中科院分区：
文献类型：
--
作者：
Wang L;Peng P;Zhang O;Xu X;Yang S;Zhao Y;Zhou Y
有证据表明，高剂量他汀类药物预处理可降低某些患者围手术期心肌梗死（PMI）和主要不良心脏事件（MACE）的风险;然而，既往分析未考虑有他汀类药物维持治疗史的患者。在这项随机对照试验（RCT）的荟萃分析中，我们重新评估了短期高剂量他汀类药物预处理在接受择期经皮冠状动脉介入治疗的患者中预防PMI和MACE的有效性。我们在PubMed/Medline数据库中检索了比较高剂量他汀类药物预处理与无他汀类药物或低剂量他汀类药物预处理预防PMI和MACE的RCT。我们评估了PMI和MACE的发生率，包括死亡、自发性心肌梗死和靶血管血运重建，每个研究的亚组按疾病分类和既往低剂量他汀类药物治疗分层。确定了24项RCT，共计5，526例患者。高剂量他汀类药物预处理与PMI相对降低59%（比值比[OR]：0.41; 95%置信区间[CI]：0.34-0.49; P<0.00001）和MACE相对降低39%（OR：0.61; 95% CI：0.45-0.83; P = 0.002）相关。 对于他汀类药物初治患者（OR：0.69; 95% CI：0.50-0.95; P = 0.02）和既往接受过低剂量他汀类药物治疗的患者（OR：0.28; 95% CI：0.12-0.65; P = 0.003），以及急性冠脉综合征患者（OR：0.52; 95% CI：0.34-0.79; P = 0.003），高剂量他汀类药物预处理对MACE的获益显著，但对于稳定型心绞痛患者（OR：0.71; 95% CI：0.45-1.10; P = 0.12），获益不显著。 对生存的长期影响不太明显。大剂量他汀类药物预处理可显著降低择期PCI患者的PMI和MACE。高剂量他汀类药物预处理对PMI和MACE的积极影响对于他汀类药物初治患者和既往治疗患者具有显著意义。大剂量他汀类药物预处理对急性冠状动脉综合征患者的MACE有积极影响。
Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34–0.49; P<0.00001) and 39% relative reduction in MACE (OR: 0.61; 95% CI: 0.45–0.83; P = 0.002). The benefit of high-dose statin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50–0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12–0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34–0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45–1.10; P = 0.12). Long-term effects on survival were less obvious. High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients with prior treatment. The positive effect of high-dose statin pretreatment on MACE is significant for patients with acute coronary syndrome.
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DOI：
10.1161/circinterventions.110.959080
发表时间：
2010-12-01
影响因子：
5.6
作者：
Lansky, Alexandra J.;Stone, Gregg W.
通讯作者：
Stone, Gregg W.
影响因子：
4.8
作者：
Macin, SM;Perna, ER;Badaracco, R
通讯作者：
Badaracco, R
影响因子：
24
作者：
Di Sciascio, Germano;Patti, Giuseppe;Montinaro, Antonio
通讯作者：
Montinaro, Antonio
影响因子：
2.3
作者：
Feldman, Dmitriy N.;Kim, Luke;Wong, S. Chiu
通讯作者：
Wong, S. Chiu
影响因子：
39.3
作者：
Briguori, C;Colombo, A;Scarpato, P
通讯作者：
Scarpato, P