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Effect of statins pretreatment on periprocedural myocardial infarction in patients undergoing percutaneous coronary

Feng Zhang1, Lili Dong, Junbo Ge

  • 1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.

Annals of Medicine
|April 14, 2010
PubMed

Insights

Preprocedure statins significantly reduce periprocedural myocardial infarction (MI) in patients undergoing percutaneous coronary intervention (PCI). This meta-analysis confirms statin pretreatment is effective in lowering MI rates and improving outcomes post-PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Periprocedural myocardial injury is a common complication of percutaneous coronary intervention (PCI).
  • Elevated cardiac enzymes post-PCI are linked to increased mortality risk.
  • Hydroxymethylglutaryl-CoA reductase inhibitors (statins) are widely used for cardiovascular risk reduction.

Purpose of the Study:

  • To evaluate the efficacy of statin pretreatment in preventing periprocedural myocardial infarction (MI) during PCI.
  • To synthesize evidence from randomized controlled trials (RCTs) on statin use before PCI.
  • To assess the impact of statins on key clinical outcomes following PCI.

Main Methods:

  • A comprehensive meta-analysis of published randomized controlled trials (RCTs) was conducted.
  • Searches included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials up to August 2009.
  • Eligible RCTs compared preprocedural statins versus placebo in statin-naive patients undergoing PCI, reporting periprocedural MI data.

Main Results:

  • Six RCTs involving 2,088 patients met the inclusion criteria.
  • Preprocedural statin use significantly reduced periprocedural MI (7.7% vs. 14.2%, OR 0.51, P<0.001).
  • A composite endpoint of death, MI, or revascularization at 1 month was also significantly lower in the statin group (8.0% vs. 15.3%, OR 0.48, P<0.001).

Conclusions:

  • Statin pretreatment is effective in reducing the incidence of periprocedural myocardial infarction in patients undergoing PCI.
  • The findings support the routine use of statins prior to PCI to mitigate procedural complications.
  • Preprocedural statins demonstrate a significant benefit in improving short-term clinical outcomes after PCI.
Abstract

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