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

Mariano García-Campa, Ramiro Flores-Ramírez, Sabrina Rojo-Garza, Edgar Francisco Carrizales-Sepúlveda, Diego Regalado-Ceballos, Raúl Reyes-Araiza, Neri Álvarez-Villalobos, Rene Rodríguez-Gutiérrez and José Ramón Azpiri-López

PLOS ONE, 2024, vol. 19, issue 1, 1-12

Abstract: 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.

Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0293404

DOI: 10.1371/journal.pone.0293404

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