This meta-analysis demonstrated the effect of intensive versus standard
statins on the risk of
stroke in patients with coronary artery syndromes (CAS). PubMed, Embase, the Cochrane library, and clinicaltrials.gov were searched, and the retrieved studies were undertaken for randomized controlled trials (RCTs) throughout September 2018. Studies that were designed as RCTs and recruited at least 1000 CAS patients followed up greater than 1 year were eligible for this study. The summary relative risk with the 95% confidence interval was used as an effect estimate and calculated using the random-effects model. Five RCTs comprising a total of 39,612 coronary syndrome patients with reported 1236
stroke events were included in this meta-analysis. The summary result indicated a 14% reduction in the risk of
stroke in CAS patients receiving intensive
statin therapy as compared to standard
statin therapy. The significant differences mainly occurred in mean age ≥60 years (P = 0.007), percentage of males ≥80% (P = 0.011), percentage
diabetes mellitus ≥ 15% (P = 0.018), percentage
hypertension ≥50% (P = 0.030), percentage of current smokers <30% (P = 0.011), percentage of prior
myocardial infarction ≥50% (P = 0.011), percentage of
peripheral arterial disease ≥10% (P = 0.030), patients with stable CAS (P = 0.011), patients using
atorvastatin (P = 0.015), follow-up duration ≥3 years (P = 0.011), and study with moderate quality (P = 0.013). Intensive
statin therapy should be considered for CAS patients at high risk of
stroke events. Further large-scale RCT should be conducted to verify the results of stratified analysis in this study.