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Role of statins in preventing cardiac surgery-associated acute kidney injury: an
updated meta-analysis of randomized controlled trials
#MMPMID29551897
He SJ
; Liu Q
; Li HQ
; Tian F
; Chen SY
; Weng JX
Ther Clin Risk Manag
2018[]; 14
(?): 475-482
PMID29551897
show ga
BACKGROUND: The prevention of cardiac surgery-associated acute kidney injury
(CSA-AKI) by statins remains controversial. Therefore, the present meta-analysis
including randomized controlled trials (RCTs) was performed to assess the effect
of perioperative statin on CSA-AKI. METHODS: Two reviewers independently searched
for RCTs about perioperative statin for prevention of CSA-AKI. The primary
endpoint was CSA-AKI. Relative risk was calculated between statin and placebo for
preventing CSA-AKI using the random-effect model or fixed-effect model according
to different heterogeneity. RESULTS: Eight RCTs met inclusion criteria, including
five studies with atorvastatin, two with rosuvastatin, and one with simvastatin.
There were 1,603 patients receiving statin treatment and 1,601 with placebo.
Perioperative statin therapy did not reduce the incidence of CSA-AKI (relative
risk =1.17, 95% CI: 0.98-1.39, p=0.076). Furthermore, perioperative statin
increased the risk of CSA-AKI in the subgroup analysis with clear definition of
CSA-AKI and those with JADAD score >3. Perioperative rosuvastatin produced
slightly significantly higher risk of AKI than atorvastatin therapy (p=0.070).
Statin intervention both pre and post surgery slightly increased the risk of
CSA-AKI versus preoperative statin therapy alone (p=0.040). CONCLUSIONS:
Perioperative statin therapy might increase the risk of CSA-AKI after cardiac
surgery.
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