Physicians' Academy for Cardiovascular Education

Reduced CV events with loading dose of statin before PCI in patients with ACS

Short-term and long-term effects of a loading dose of atorvastatin before percutaneous coronary intervention on major adverse cardiovascular events in patients with acute coronary syndrome: a meta-analysis of 13 randomized controlled trials

Literature - Ye Z, Lu H, Su Q et al. - Eur Heart J 2019;0,1-10

Introduction and methods

Although a loading dose of statin can significantly reduce the incidence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), especially the incidence of myocardial infarction (MI) [1-9], it remains unclear whether a loading dose of atorvastatin can reduce the incidence of MACE in patients with acute coronary syndrome (ACS) after PCI. This meta-analysis (n=22.095) therefore estimated the effects of a loading dose of atorvastatin (80 mg) (50.7%) vs. conventional therapy (49.3%) before PCI on MACE in patients with ACS.

Inclusions criteria were as follows: diagnosis of ACS, randomized controlled trial, loading dose of atorvastatin was 80 mg before a planned PCI, control group received conventional therapy, and sufficient data available for analysis. Primary endpoints were all-cause mortality and MACE (composite of non-fatal MI, rehospitalization, revascularization, and stroke). In total 13 trials were included and for subanalysis divided into two groups based on the time of follow-up: short-term (≤30 days)(7 studies) and long-term (>30 days)(3 studies).

Main results

Conclusion

This meta-analysis of 13 randomized controlled trials showed that a loading dose of atorvastatin (80 mg) before PCI markedly reduced MACE (non-fatal MI, rehospitalization, revascularization, and stroke) in patients with ACS.

References

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Find this article online at Eur Heart J

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