Statins in prevention of repeat revascularization after percutaneous coronary intervention--a meta-analysis of randomized clinical trials

Pharmacol Res. 2010 Apr;61(4):316-20. doi: 10.1016/j.phrs.2009.11.004. Epub 2009 Nov 14.

Abstract

Recent prospective cohort studies have shown that patients discharged on statins after percutaneous coronary intervention (PCI) are at lower risks of repeat revascularization and mortality when compared to those not on statins after discharge. However, few randomized clinical trials among post-PCI patients confirmed these beneficial effects. It is needed to evaluate the effects of post-procedural statin therapy on individual clinical outcomes to facilitate the further investigation on identifying the underlying mechanism(s). A meta-analysis of randomized clinical trials was conducted to examine the effects of statin therapy initiated after coronary angioplasty on repeat revascularization, all-cause mortality and myocardial infarction (MI). From relevant reports on Medline (from inception to October 2009), six randomized clinical trials comprising 2979 patients were included. Relative risks were evaluated for pooled data via random effect models. Compared with controls, post-PCI statin therapy was associated with a significantly decreased risk of repeat revascularization (risk ratio (RR)=0.73, 95% confidence interval (CI), 0.55-0.98, p=0.04), nonsignificantly decreased risks of all-cause mortality (RR=0.88, 95% CI, 0.35-2.21, p=0.79), MI (RR=0.76, 95% CI, 0.49-1.18, p=0.23), and target lesion or target vessel revascularization (RR=0.58, 95% CI, 0.24-1.39, p=0.22). In conclusion, statin therapy after PCI can reduce the risk of repeat revascularization. Further investigation is needed to identify the underlying mechanism(s).

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / mortality*
  • Angioplasty, Balloon / statistics & numerical data*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / prevention & control*
  • Myocardial Infarction / therapy
  • Myocardial Revascularization / adverse effects
  • Myocardial Revascularization / mortality*
  • Myocardial Revascularization / statistics & numerical data*
  • Randomized Controlled Trials as Topic
  • Risk Assessment

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors