Background:The prophylactic efficacy of statin pretreatment for the prevention of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) remains controversial. The aim of the study was to perform a meta-analysis of randomized controlled trials (RCTs) to assess the effectiveness of short-term moderate or high-dose rosuvastatin pretreatment in preventing CIN.Methods:We included RCTs comparing short-term moderate or high-dose rosuvastatin treatment versus low-dose rosuvastatin treatment or placebo for preventing CIN. The primary endpoint was the incidence of CIN within 2 to 5 days after contrast administration, and related-parameters including serum creatinine (SCr), cystatin C (CysC), hypersensitive C-reactive protein (hs-CRP), urine microalbumin (mALB) were also extracted.Results:Fifteen RCTs with a total of 2673 patients were identified and analyzed. Patients who received moderate or high-dose rosuvastatin pretreatment had a 55% lower risk of CIN compared with low-dose rosuvastatin pretreatment or placebo group based on a fixed effect model (RR = 0.45, 95% CI 0.35–0.58, P < .0001). The benefit of moderate or high-dose rosuvastatin was consistent in both comparisons with low-dose rosuvastatin (RR = 0.40, 95% CI 0.27–0.59, P < .0001) or placebo (RR = 0.45, 95% CI 0.35–0.58, P < .0001). And moderate (20 mg) or high dose (≥40 mg) rosuvastatin significantly reduced the incidence of CIN compared with the control (RR = 0.39, 95% CI 0.29–0.54, P < .0001, RR = 0.56, 95% CI 0.37–0.85, P = .006, respectively). Subgroup analysis showed that moderate or high-dose rosuvastatin pretreatment could decrease the incidence of CIN in patients with chronic kidney disease (CKD) (RR = 0.53, 95% CI 0.30–0.93, P = .03) or diabetes mellitus (DM) (RR = 0.51, 95% CI 0.31–0.86, P = .01) or acute coronary syndrome (ACS) patients undergoing PCI (RR = 0.52, 95% CI 0.35–0.76, P = .0009) or in studies which received mean contrast volume ≥110 mL (RR = 0.43, 95% CI 0.32–0.58, P < .0001). The SCr, CysC, hs-CRP, and mALB after the operation in the moderate or high-dose rosuvastatin group were lower than those of low-dose rosuvastatin group.Conclusion:This meta-analysis demonstrated that moderate or high-dose rosuvastatin treatment could reduce the incidence of CIN in patients undergoing CAG or PCI. Moreover, moderate or high-dose rosuvastatin would be beneficial in high-risk patients with CKD or DM or undergoing PCI.

Introduction The coronavirus disease 2019 (COVID-19) was defined as a species of beta coronavirus causing atypical respiratory disease in humans. The COVID-19 pandemic has resulted in an unprecedented health and economic crisis worldwide. Little is known about the specifics of its influence on people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). In this study, we aim to investigate the prevalence and mortality in PLWHA co-infected with COVID-19. Methods The databases PUBMED, EMBASE, BioRxiv, and medRxiv were searched up to 9 March 2021 to explore the prevalence and mortality rate of COVID-19 in PLWHA. Cohort studies and case series meeting the inclusion criteria were included in this review. Results We identified 14 eligible studies, 9 of which were cohort and 5 were case series. A total of 203,761 patients with COVID-19 were identified (7718 PLWHA vs. 196,043 non-PLWHA). Meta-analyses estimated the prevalence and mortality rate of COVID-19 in PLWHA was 0.774% [95% confidence interval (CI) 0.00393–0.01517] and 8.814% (95% CI 0.05766–0.13245) respectively. COVID-19 co-infected PLWHA do not seem to be associated with higher mortality, as compared to non-PLWHA [relative risk (RR) 0.96 (95% CI 0.88–1.06)]. The presence of comorbidities such as diabetes mellitus, RR 5.2 (95% CI 4.25–6.36), hypertension and chronic cardiac disease, RR 4.2 (95% CI 1.09–16.10), and chronic kidney disease, RR 8.43 (95% CI 5.49–12.93) were associated with an increased mortality in COVID-19 co-infected PLWHA. Conclusion The estimated prevalence and mortality rate of COVID-19 in PLWHA were 0.774% and 8.814%, respectively. Since most of the included studies used unmatched populations, comparisons between PLWHA and non-PLWHA should be interpreted with caution. Further investigations are needed for a more comprehensive understanding of the relationship between cluster of differentiation 4 cell count, HIV viral load, antiretroviral therapy, and COVID-19 related prognosis in PLWHA. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00447-1.

Probucol combined with hydration more effectively decreased the incidence of CIN in patients with coronary heart disease undergoing PCI compared with hydration alone.

Prophylactic administration of alprostadil may prevent against CIN in coronary heart disease patients undergoing elective PCI, particularly in high-risk patients with diabetes mellitus.