Atorvastatin before percutaneous coronary intervention: A systematic review and meta-analysis.

Autor: García-Campa M; Cardiology Service, 'Dr. José Eleuterio González' University Hospital of the Autonomous University of Nuevo Leon, Monterrey, Mexico.; Plataforma INVEST UANL-KER Unit Mayo Clinic, School of Medicine and University Hospital 'Dr. José E González', Autonomous University of Nuevo Leon, Monterrey, Mexico., Flores-Ramírez R; Cardiology Service, 'Dr. José Eleuterio González' University Hospital of the Autonomous University of Nuevo Leon, Monterrey, Mexico., Rojo-Garza S; Plataforma INVEST UANL-KER Unit Mayo Clinic, School of Medicine and University Hospital 'Dr. José E González', Autonomous University of Nuevo Leon, Monterrey, Mexico., Carrizales-Sepúlveda EF; Cardiology Service, 'Dr. José Eleuterio González' University Hospital of the Autonomous University of Nuevo Leon, Monterrey, Mexico., Regalado-Ceballos D; Plataforma INVEST UANL-KER Unit Mayo Clinic, School of Medicine and University Hospital 'Dr. José E González', Autonomous University of Nuevo Leon, Monterrey, Mexico., Reyes-Araiza R; Cardiology Service, 'Dr. José Eleuterio González' University Hospital of the Autonomous University of Nuevo Leon, Monterrey, Mexico., Álvarez-Villalobos N; Plataforma INVEST UANL-KER Unit Mayo Clinic, School of Medicine and University Hospital 'Dr. José E González', Autonomous University of Nuevo Leon, Monterrey, Mexico., Rodríguez-Gutiérrez R; Plataforma INVEST UANL-KER Unit Mayo Clinic, School of Medicine and University Hospital 'Dr. José E González', Autonomous University of Nuevo Leon, Monterrey, Mexico., Azpiri-López JR; Cardiology Service, 'Dr. José Eleuterio González' University Hospital of the Autonomous University of Nuevo Leon, Monterrey, Mexico.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jan 02; Vol. 19 (1), pp. e0293404. Date of Electronic Publication: 2024 Jan 02 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0293404
Abstrakt: Atorvastatin is widely recommended for long-term secondary prevention in STEMI patients with no contraindication. Although high-dose atorvastatin has been shown to reduce important patient outcomes such as MACE, there is still doubt that high-dose atorvastatin could have the same protective effect in patients undergoing PCI in the short and long term. We searched the following electronic databases: Scopus, Web of Science, MEDLINE, EMBASE, and Cochrane Central considering studies that enrolled adult patients with a confirmed diagnosis of STEMI or NSTEMI undergoing PCI. The intervention must have been atorvastatin alone compared to a placebo, standard care, or a different atorvastatin dose. A total of (n = 11) studies were included in the quantitative analysis. Information on (N = 5,399) patients was available; 2,654 were assigned to receive high-dose atorvastatin therapy, and 2,745 comprised the control group. High-dose atorvastatin pre-loading significantly reduced MACE at one month of follow-up (RR: 0.78; 95% CI: 0.67-0.91; p = 0.014) in both STEMI and NSTEMI. All-cause mortality was reduced in patients with STEMI (RR: 0.28; 95% CI: 0.10-0.81; p = 0.029). The quality of the body of evidence was rated overall as moderate. Patients presenting with STEMI or NSTEMI benefit from high-dose atorvastatin pre-loading before PCI by reducing MACE at 30 days. The use of high-dose atorvastatin in STEMI patients reduced all-cause mortality. The beneficial effects of atorvastatin pre-loading are limited to 30 days post-PCI.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 García-Campa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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