Rosuvastatin Treatment for Preventing Contrast-Induced Acute Kidney Injury After Cardiac Catheterization

Abstract

We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the protective effects of rosuvastatin on contrast-induced acute kidney injury (CI-AKI) and major adverse cardiovascular events (MACEs) in patients undergoing cardiac catherization.PubMed, MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central RCTs were searched for RCTs from inception to May 2015, to compare rosuvastatin for preventing CI-AKI with placebo treatment in patients undergoing cardiac catherization.Five RCTs with a total of 4045 patients involving 2020 patients pretreated with rosuvastatin and 2025 control patients were identified and analyzed. Patients treated with rosuvastatin had a 51% lower risk of CI-AKI compared with the control group based on a fixed-effect model (OR = 0.49, 95% CI = 0.37–0.66, P < 0.001), and showed a trend toward a reduced risk of MACEs (OR = 0.62, 95% CI = 0.36–1.07, P = 0.08). A subgroup analysis showed that studies with Jadad score ≥3 showed a significant reduction of CI-AKI (OR = 0.53, 95% CI, 0.38–0.73, P < 0.001). However, the risk of CI-AKI did not significantly differ in the studies with Jadad score <3 (OR = 0.54, 95% CI, 0.13–2.24, P = 0.40). In addition, the rosuvastatin treatment showed no effect for preventing CI-AKI in patients with chronic kidney disease (CKD) undergoing elective cardiac catherization (I2 = 0%, OR = 0.81, 95% CI = 0.41–1.61, P = 0.55).This updated meta-analysis demonstrated that preprocedural rosuvastatin treatment could significantly reduce the incidence of CI-AKI, with a trend toward a reduced risk of MACEs in patients undergoing cardiac catheterization. However, rosuvastatin treatment did not seem to be effective for preventing CI-AKI in CKD patients undergoing elective cardiac catheterization.

Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients

“…Several meta-analyses showed lower overall PC-AKI rates with the use of high-dose, short-term statin treatment compared to controls [ 95 – 105 ]. Lower PC-AKI rates were also found in subgroups, such as older patients, patients with acute coronary syndromes and for high-dose statin regimes.…”

Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery

“… 1 , 3 – 11 Acute kidney injury is associated with up to 60% mortality rates in cardiac surgery patients, 12 and the risk of death associated with AKI remains high for 10 years, even for those patients with complete renal recovery. 1 As there is no effective therapy available for AKI after cardiovascular surgery, 13 , 14 accurate prediction of AKI may provide an opportunity to develop strategies for early diagnosis and intervention to optimize outcomes. 10 , 15 , 16 …”

Statins role in preventing contrast-induced acute kidney injury: a scoping review

“…However, in another experimental study, rosuvastatin was found to yield better outcomes than simvastatin and atorvastatin. 25 Yang et al 26 performed a meta-analysis of five randomised controlled trials including a total of 4045 patients that compared the effects of rosuvastatin versus placebo and discovered that rosuvastatin administration prior to cardiac catheterisation caused a notable decrease in the risk of CI-AKI. However, since only one type of statin was used, comparisons could not be made among different types of statins.…”