Table 4.
Prospective, randomized clinical trials comparing efficacy of statins and placebo for contrast-induced AKI after angiography prophylaxis.
| Authors | Year | Type of procedure and contrast media | Number of patients Intervention versus control |
Study protocol | Intravascular volume expansion and NAC protocol | CI-AKI definition | Mean GFR Intervention versus control (mL/min/1.73 m2) |
Incidence of CI-AKI | RRT requirement Intervention versus control (%) |
||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Intervention | Control | Intervention versus control (%) | P value | ||||||||
| Xinwei et al. [73] | 2009 | CAG Iodixanol |
115 versus 113 | Simvastatin 20 mg/d | Simvastatin 80 mg/d before and 20 mg after | NSS 1 mL/kg/h 6–12 hours before and 12 hours after | ↑Cr ≥25%/2 days or ↑Cr ≥0.5/2 days |
86.5 versus 93.6 | 15.7 versus 5.3 | <0.05 | ND |
|
| |||||||||||
| Patti et al. [77] | 2011 | CAG Iobitridol |
120 versus 121 | Atorvastatin 80 mg 12 hours and 40 mg 2 hours before | Placebo | NSS 1 mL/kg/h ≥ 12 hours before and 24 hours after |
↑Cr ≥25%/1-2 days or ↑Cr ≥0.5/1-2 days |
79.8 versus 77.0 | 5 versus 13.2 | 0.046 | 0 versus 0.8 |
|
| |||||||||||
| Quintavalle et al. [78] | 2012 | CAG Iodixanol |
202 versus 208 | Atorvastatin 80 mg 1 days before | None | Isotonic NaHCO3 3 mL/kg/h 1 hour and 1 mL/kg/h 6 hours NAC 1200 mg po bid |
↑CysC ≥10%/1 day ↑Cr ≥25%/2 days or ↑Cr ≥0.5/2 days |
42 versus 43 | 4.5 versus 17.8 | 0.005 | ND |
|
| |||||||||||
| Jo et al. [74] | 2008 | CAG Iodixanol |
124 versus 123 | Simvastatin 40 mg po q12h for 2 days | Placebo | N/2 1 mL/kg/h 12 hours before and after | ↑Cr ≥25%/2 days or ↑Cr ≥0.5/2 days |
53.46 versus 55.4 | 2.5 versus 3.4 | 1.0 | 0 versus 0.8 |
|
| |||||||||||
| Özhan et al. [75] | 2010 | CAG ND |
Total 130 | Atorvastatin | None | NAC | ND | ND | 2 patients versus 7 patients* | NS | ND |
|
| |||||||||||
| Toso et al. [76] | 2010 | CAG Iodixanol |
152 versus 152 | Atorvastatin 80 mg/d 2 days before and after | Placebo | NSS 1 mL/kg/h 12 hours before and after NAC 1200 mg po bid |
↑Cr ≥0.5/5 days or ↑Cr ≥25%/5 days |
46 versus 46 | 9.7 versus 11.2 | NS NS |
0 versus 0.7 |
|
| |||||||||||
| Han et al. [79] | 2013 | CAG/PAG Iodixanol |
1498 versus 1500 | Rosuvastatin 10 mg/d 2 days before and 3 days after | None | NSS 1 mL/kg/h 12 hours before and 24 hours after | ↑Cr ≥25%/3 days or ↑Cr ≥0.5/3 days |
74.16 versus 74.43 | 2.3 versus 3.9 | 0.01 | 0 versus 0.1 |
|
| |||||||||||
| Leoncini et al. [80] | 2013 | CAG Iodixanol |
252 versus 252 | Rosuvastatin 40 mg on admission then 20 mg/d | None | NSS 1 mL/kg/h 12 hours before and after NAC 1200 mg po bid |
↑Cr ≥25%/3 days or ↑Cr ≥0.5/3 days |
82.5 versus 82.6 | 6.7 versus 15.1 | 0.003 | 0 versus 0.1 |
*The incidences of CI-AKI data in each group are not available. Data is shown as the number of patients who develop CI-AKI.
bid: twice daily; CAG: coronary angiography; CI-AKI: contrast-induced acute kidney injury; Cr: creatinine; CysC: cystatin C; d: day; h: hour; IV: intravenous; kg: kilogram body weight; mg: milligram; mL: milliliter; NAC: N-acetylcysteine; ND: no data; NSS: normal saline solution; N/2: 0.45% NaCl; po: per oral route; PAG: peripheral angiography; q12h: every 12 hours; RRT: renal replacement therapy.