Meta-Analysis of Medium and Long-Term Efficacy of Loading Statins After Coronary Artery Bypass Grafting.

Abstract

The aim of this study was to evaluate the medium- and long-term efficacy of loading statins after coronary artery bypass grafting (CABG) by comparing using a loading dose of statins or a regular dose of statins in patients undergoing CABG. We conducted a literature search of numerous databases for randomized controlled trials on the efficacy of a loading dose of statins in patients undergoing CABG. The quality of included studies was evaluated according to the Newcastle-Ottawa Scale. Statistical results of treatment were represented by weighted mean difference, odds ratio, and 95% confidence interval. There were 8 studies including 8,676 patients (4,352 who had a loading dose of statins and 4,324 who had a regular dose). Meta-analysis showed statistically significant differences in the following in patients who took a loading dose of statins: lower level of low-density lipoprotein cholesterol (LDL-C) after CABG (p < 0.00001), fewer deaths caused by myocardial infarction (p = 0.005), fewer patients with myocardial infarction (p = 0.004), fewer patients undergoing secondary CABG (p < 0.00001), and fewer patients undergoing graft restenosis by intravascular ultrasonography (p < 0.0001). Comparing patients receiving a loading dose of statins with those receiving a regular dose after CABG, the medium- and long-term efficacy of a loading dose showed significant reduction in LDL-C, lower occurrence of adverse cardiac events, and reduction in graft restenosis. Although the incidence of drug-related side effects was slightly higher in the loading-dose group, in the majority of patients they were not serious. Overall, a loading dose of statins is superior to regular dosing of statins after CABG.