Abstract 281: A Network Meta-analysis Exploring High-intensity Atorvastatin In Contrast Induced Nephropathy

Introduction: The utility of pre-procedure statins prior to coronary angiography has been utilized as an adjunct in the prevention of contrast-induced nephropathy (CIN). This has been attributed to the pleotropic and anti-inflammatory effects of the statin. Whether there is a dose and intensity dependent effect on the prevention of CIN is unknown.

Methods: We performed a hierarchical network meta-analysis on all published randomized-controlled trials up to March 2020 to determine whether high-intensity atorvastatin (40mg or 80mg) was superior to lower intensity atorvastatin (20mg or less) and high-intensity or low-intensity statins. We searched PubMed, MEDLINE, Embase, Web of Science and Cochrane database for randomized-controlled studies without restriction to language. Studies published in Chinese was translated using Google Translate. Network meta-analysis was performed using NetMetaXL version 1.6.1.

Results: We analyzed 49 trials, comprised of 13,395 patients, comparing five arms of treatment: Moderate/High intensity atorvastatin, Low intensity atorvastatin, Moderate/High intensity other statin, Low intensity other statin and None. There were 1,029 events for CIN (7.68%). In pairways comparisons, Moderate/High intensity atorvastatin reduced CIN by 0.70 (95% CI: 0.54-0.91) when compared to placebo. When compared to Moderate/High intensity other statins, the difference was not statistically significant (95% CI: 0.50-1.08).

Conclusion: Moderate to High Dose Atorvastatin was not superior to other statins in prevention of CIN. Further investigation into the anti-inflammatory properties of statins may be helpful in understanding the role of statins as adjunct treatment to standard of care in preventing CIN.