Peruzzi Mariangela, De Luca Leonardo, Thomsen Henrik S, Romagnoli Enrico, D'Ascenzo Fabrizio, Mancone Massimo, Sardella Gennaro, Lucisano Luigi, Abbate Antonio, Frati Giacomo, Biondi-Zoccai Giuseppe
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy.
Department of Cardiovascular Sciences, European Hospital, 00149 Rome, Italy.
Biomed Res Int. 2014;2014:213239. doi: 10.1155/2014/213239. Epub 2014 Sep 7.
Contrast-induced nephropathy is a common complication of iodinated contrast administration. Statins may reduce the risk of contrast-induced nephropathy, but data remain inconclusive. We summarized the evidence based on statins for the prevention of contrast-induced nephropathy with a network meta-analysis. Randomized trials focusing on statins were searched and pooled with random-effect odds ratios. A total of 14 trials (6,160 patients) were included, focusing on atorvastatin (high/low dose), rosuvastatin (high dose), simvastatin (high/low dose), and placebo or no statin therapy before contrast administration. The risk of contrast-induced nephropathy was reduced by atorvastatin high dose and rosuvastatin high dose, with no difference between these two agents. Results for atorvastatin low dose and simvastatin (high/low dose) in comparison to placebo were inconclusive. Atorvastatin and rosuvastatin administered at high doses and before iodinated contrast administration have a consistent and beneficial preventive effect on contrast-induced nephropathy and may actually halve its incidence.
对比剂肾病是使用碘化对比剂时常见的并发症。他汀类药物可能会降低对比剂肾病的风险,但相关数据仍无定论。我们通过网状Meta分析总结了基于他汀类药物预防对比剂肾病的证据。检索了聚焦于他汀类药物的随机试验,并采用随机效应比值比进行汇总。共纳入14项试验(6160例患者),重点关注阿托伐他汀(高/低剂量)、瑞舒伐他汀(高剂量)、辛伐他汀(高/低剂量),以及对比剂给药前使用安慰剂或不使用他汀类药物治疗的情况。高剂量阿托伐他汀和高剂量瑞舒伐他汀可降低对比剂肾病的风险,这两种药物之间无差异。低剂量阿托伐他汀和辛伐他汀(高/低剂量)与安慰剂相比的结果尚无定论。高剂量阿托伐他汀和瑞舒伐他汀在碘化对比剂给药前使用,对对比剂肾病具有一致且有益的预防作用,实际上可能会使其发生率减半。