Clinical efficacy and safety of statin treatment after carotid artery stenting

Abstract

Objective: The randomized controlled trail was carried out to investigate the influence of statin pretreatment on clinical efficacy of carotid artery stenting (CAS). Methods: 160 eligible patients were randomly divided into statin group (n ¼ 82) and control group (n ¼ 78). The patients in statin group received 40 mg atorvastatin daily 7 days before operation. Major endpoints included transient ischemic attack (TIA), stroke, death, myocardial infarction (MI), and other cardiac adverse events within 30 days after CAS. Results: Preoperative baseline information was similar between the statin and control groups (p > 0.05 for all). Within 48 h after operation, the occurrence rate of CIN (3.66% vs 8.97%, p ¼ .019) and new infarction (4.88% vs. 14.10%, p ¼ .045) were significantly lower in statin group than in control group. 30 days after CAS, the incidences of TIA (12.20% vs. 26.92%, p ¼ .018), ischemic stroke (6.10% vs. 16.67%, p ¼ .034), and other cardiac complications (7.32% vs. 19.23%, p ¼ .026) were also significantly lower in statin group, than in the control group. Multiple analysis demonstrated that statin use exerted protective effect against ischemic stroke (OR ¼ 0.038, 95% CI ¼ 0.003-0.543, p ¼ .016) and other cardiac complications (OR ¼ 0.208, 95%CI ¼ 0.063-0.694, p ¼ .011). Conclusion: Pre-treatment with statin is an effective and safe strategy to prevent from perioperative complications and to improve postoperative outcomes in patients undergoing CAS. ARTICLE HISTORY

A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

“…Since then, one randomized control trial (RCT) and three retrospective studies have been published with controversial results. In particular, the RCT confirmed that patients receiving statins had a lower incidence of post-operative TIAs and stroke in comparison to placebo receivers [91]. However, the latest three retrospective studies did not detect any benefit from statin administration in terms of stroke incidence [92][93][94].…”

Impact of atorvastatin reload on the prevention of contrast-induced nephropathy in patients on chronic statin therapy: A prospective randomized trial

“…They may also reduce the reabsorption of contrast agents in renal tubules [ 1 , 10 , 12 , 13 , 28 – 37 ]. Previous studies had shown that loading doses with statins in pre-treated patients before PCI could reduce the myocardial damage and intra-hospital cardiac events, possibly via antioxidant and anti-inflammatory effects, as well as endothelin secretion [ 29 , 37 , 38 ]. Early observational trials and meta-analyses on statin failed to show its beneficial effects on CIN prevention.…”

Effect of Statins on Serum level of hs-CRP and CRP in Patients with Cardiovascular Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Seventeen publications with 26 arms including 3010 participants who received statins and 2968 participants in control groups who did not receive statins or received placebo were included in this meta-analysis. Among them, 12 publications were performed in Asian countries [47][48][49][50][51][52][53][54][55][56][57], 4 publications in European countries [58][59][60][61], and only one study in the USA [62]. Overall population analysis showed that statins decreased the serum level of hs-CRP (WMD = −0:97 mg/L; 95% CI: -1.26 to -0.68 mg/L; P < 0:001; I 2 : 98.2, P heterogeneity > 0:001, Figure 2).…”