High-dose atorvastatin reduces the risk of cardiovascular events in patients with percutaneous coronary intervention

// Changqing Lu 1 , Helei Jia 1 and Zhentao Wang 2 1 Department of Emergency, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, Henan Province 450002, China 2 Department of Cardiovascular Disease, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, Henan Province 450002, China Correspondence to: Zhentao Wang, email: wangzhentaodoc@126.com Keywords: percutaneous coronary intervention, atorvastatin, intervention, meta-analysis, randomized controlled trials Abbreviation: PCI, percutaneous coronary intervention Received: April 18, 2017 Accepted: June 19, 2017 Published: July 31, 2017 ABSTRACT We systematically searched in PubMed, Web of Science, Embase and China National Knowledge Infrastructure from the inception to March 31, 2017, identified relevant trials about efficacy of high-does Atorvastatin for patients with percutaneous coronary intervention. Twelve studies with the number of 2801 patients were included in the meta-analysis. Compared with control group, high-does Atorvastatin significantly reduced the risk of myocardial infarction in patients with percutaneous coronary intervention (Relative risk =0.62, 95% confidence interval: 0.49-0.78), with low level of heterogeneity (I 2 =22.6%, P=0.228). Nine studies with 2248 patients reported the adverse cardiovascular events. A fixed-effect model was applied. Compared with control group, patients with high-does Atorvastatin taken, the risk of adverse cardiovascular events was degraded by 65% (Relative risk, RR=0.65, 95% confidence interval (CI): 0.50-0.84), which was confirmed by trial sequential analysis as the cumulative Z curve entered the futility area. The subgroup analyses found that decreased risks of myocardial infarction among trails (RR=0.64, 95%CI: 0.50-0.83, RR=0.55, 95%CI: 0.34-0.88). Egger and Begg’s test found no publication bias (t=-1.670, P =0.129; Z=1.560, P =0.119). The use of high-dose Atorvastatin could reduce the risk of myocardial infraction and cardiovascular adverse events in patients with percutaneous coronary intervention. High-dose Atorvastatin was recommended as an adjunct to aid percutaneous coronary intervention.