The following is a summary of “A systematic review and meta-analysis of the effect of high-intensity statin on coronary microvascular dysfunction,” published in the July 2023 issue of Cardiology by Huang et al.
Researchers performed a retrospective study to examine the high-intensity statin effects on coronary microvascular dysfunction in coronary heart disease (CHD) patients who underwent percutaneous coronary intervention (PCI).
The study used randomized controlled trials (RCTs). It involved the high-intensity statin pretreatment as active treatment and measured thrombolysis in myocardial infarction (TIMI), myocardial blush grade (MBG), or index of microvascular resistance (IMR) in patients with CHD undergoing PCI. Additionally, they used the I2 test to evaluate heterogeneity, and Standard Mean Difference (SMD) with 95% CI were aggregate findings of this analysis. Subgroup analyses, quantitative Egger’s test and funnel plot, and sensitivity analyses were also performed.
Out of 20 RCTs and TIMI < 3, data was available in 18 studies. The study showed after PCI, high-intensity statin pretreatment significantly improved TIMI (RR = 0.62, 95% CI: 0.50 to 0.78, P < 0.0001). However, MBG < 2 data was in three studies, but no significant difference was found between the groups (RR = 1.29, 95% CI: 0.87 to 1.93, P = 0.21). IMR data available from two studies showed that high-dose statin pretreatment improved IMR after PCI (SMD = -0.94, 95% CI: -1.47 to -0.42, P = 0.0004). Subgroup analyses based on statin type and diagnosis did not indicate substantial differences. Furthermore, there was no indication of publication bias as assessed by the quantitative Egger’s test (P = 0.97) and funnel plot.
The study concluded that high-intensity statin pretreatment significantly improved TIMI and IMR after PCI and emphasized the need for future RCTs with high-quality and large samples to validate these findings.
Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03402-9