BACKGROUND For
coronary artery disease,
percutaneous coronary intervention (PCI) is the preferred treatment.
Reperfusion injury is a common and serious complication of PCI. Studies showed that early
statin therapy has a favorable prognostic impact for patients undergoing PCI. However, the effects of
statins on improving post-PCI myocardial perfusion are still unclear. In this study we evaluated the potential effect of high-dose
statin pretreatment on postprocedure myocardial perfusion and
MACE rate in patients receiving PCI. MATERIAL AND METHODS We searched randomized controlled trials that evaluated the effect of high-dose
statin pretreatment on post-PCI TIMI flow grade and
MACE in patients undergoing PCI from the databases of PubMed, Embase, and Cochrane Library. All data were pooled for analysis and were stratified by type of
statin, clinical presentation, and current
statin therapy status in subgroup. RESULTS Fifteen RCTs with 4240 individuals were selected. The pooled analysis showed that high-dose
statin pretreatment before PCI significantly improved the final TIMI flow grade compared with the control group (OR=0.61, 95% CI: 0.46 to 0.80, p=0.0005), and showed reduced incidence of
MACE (OR=0.53, 95%CI: 0.39 to 0.71, p<0.0001). In subgroup analysis, the beneficial effect of high-dose
statin was significant in
statin-naive treatment patients, ACS patients, and patients on
atorvastatin therapy, but no difference occurred in
rosuvastatin, previous
statin therapy, and
stable angina patients. CONCLUSIONS High-dose
statin pretreatment has an important effect on postprocedure myocardial perfusion by improving the TIMI flow in patients undergoing PCI, and high-dose
statin preloading also reduces the incidence of
MACE.