Intensive vs non-intensive statin pretreatment before percutaneous coronary intervention in Chinese patients: A meta-analysis of randomized controlled trials

Table 1 Characteristics of the included studies

Ref.	Sample size (intensive/non-intensive statin)	Clinical presentation	Statin medication history	Primary/elective PCI	Statin regimen before PCI	Statin regimen after PCI	Follow-up (d)	Outcome indicators
								Effectiveness	Safety
Liu et al[10], 2016	616 (307/309)	Stable angina, ACS	Statin-naïve or atorvastatin ≤ 20mg/d, or equivalent dose statin	Elective PCI	Atorvastatin 80 mg 12 h before PCI vs no statin pretreatment	40 mg/d vs 20 mg/d	30	MACE, non-fatal MI	Myalgia/myasthenia*
	182 (93/89)	STEMI	Statin-naïve or atorvastatin ≤ 20mg/d, or equivalent dose statin	Primary PCI	Atorvastatin 80 mg just before primary PCI vs no statin pretreatment	40 mg/d vs 20 mg/d	90		ALT
Jiao et al[11], 2015	72 (33/39)	NSTE-ACS	Not mentioned	Elective PCI	Rosuvastatin 20 mg 12 h before PCI + 20 mg just before PCI vs no statin pretreatment	10 mg/d	30	MACE, cardiac death, non-fatal MI, TVR
Jiao et al[12], 2015	126 (62/64)	NSTE-ACS	Not mentioned	Elective PCI	Rosuvastatin 20 mg 12 h before PCI + 20 mg just before PCI vs no statin pretreatment	10 mg/d	30		Myalgia/myasthenia
Zheng et al[7], 2015	1202 (573/629)	Stable angina, NSTE-ACS	Statin-naïve or atorvastatin ≤ 20mg/d or equivalent dose statin	Elective PCI	Atorvastatin 80 mg at night before PCI for 2 d vs atorvastatin ≤ 20 mg or equivalent dose statin at night before PCI	40 mg/d vs ≤ 20 mg/d or equivalent dose statin	30	MACE, cardiac death, non-fatal MI, TVR
Xie et al[13], 2014	159 (79/80)	NSTE-ACS	Statin-naïve	Elective PCI	Rosuvastatin 20 mg 12 h before PCI + 20 mg 2 h before PCI vs no statin pretreatment	10 mg/d	30	MACE, cardiac death, non-fatal MI, TVR
Luo et al[14], 2013	67 (31/36)	NSTE-ACS	Statin-naïve	Elective PCI	Rosuvastatin 20 mg 12 h before PCI + 20 mg 2 h before PCI vs no statin pretreatment	10 mg/d	30	MACE, cardiac death, non-fatal MI, TVR
Wang et al[15], 2013	125 (62/63)	NSTE-ACS	Statin-naïve	Elective PCI	Rosuvastatin 20 mg 2-4 h before PCI vs placebo 2-4 h before PCI	10 mg/d	30	MACE, cardiac death, non-fatal MI, TVR
Li et al[16], 2013	215 (106/109)	Stable angina	Regular statin for at least 3 mo	Elective PCI	Atorvastatin 80 mg 12 h before PCI vs 20 mg 12 h before PCI	20 mg/d	30	MACE, cardiac death, non-fatal MI, TVR
Gao et al[17], 2012	117 (59/58)	NSTE-ACS	Statin-naïve	Elective PCI	Rosuvastatin 20 mg 12 h before PCI + 10 mg 2 h before PCI vs placebo 12 h before PCI + 2 h before PCI	10 mg/d	90	MACE, cardiac death, non-fatal MI, TVR
Li et al[18], 2012	161 (78/83)	STEMI	Statin-naïve	Primary PCI	Atorvastatin 80 mg 1.5 h before PCI vs placebo 1.5 h before PCI	40 mg/d	30		ALT
Yu et al[19], 2011	81 (41/40)	NSTE-ACS	Statin-naïve	Elective PCI	Atorvastatin 80 mg 12 h before PCI + 40 mg 2 h before PCI vs placebo 12 h before PCI + 2 h before PCI	20 mg/d	30	MACE, cardiac death, non-fatal MI, TVR

PCI: Percutaneous coronary intervention; MACE: Major adverse cardiac events; MI: Myocardial infarction; NSTE-ACS: Non-ST segment elevation acute coronary syndrome; STEMI: ST segment elevation myocardial infarction; TVR: Target vessel revascularization; ALT: Alanine aminotransferase; ACS: Acute coronary syndrome.

Table 2 Baseline clinical, angiographic and procedural characteristics in the overall population

Variable	High-intensity statin/population (%)	Moderate-intensity statin/population (%)	Placebo or no statin pretreatment/population (%)
Number of patients	1524/3123 (48.8)	738/3123 (23.6)	861/3123 (27.6)
Male	1052/1524 (69.0)	521/738 (70.6)	566/861 (65.7)
Hypertension	9441524 (61.9)	489/738 (66.3)	533/861 (61.9)
Diabetes mellitus	439/1429 (30.7)	232/758 (30.6)	246/778 31.6)
Dyslipidemia	193/751 (25.7)	147/649 (22.7)	75/201 (37.3)
Smokers	537/1524 (35.2)	279/758 (36.8)	280/881 (31.8)
Previous MI	88/610 (14.4)	0/20 (0)	84/632 (13.3)
Previous PCI	159/1183 (13.4)	51/629 (8.1)	103/612 (15.2)
Previous CABG	6/500 (1.2)	0/0 (0)	6/496 (1.2)
Stable angina	230/506 (45.5)	109/109 (100)	118/398 (29.6)
NSTE-ACS	518/767 (67.5)	0/0 (0)	539/778 (69.3)
STEMI	203/478 (42.5)	0/20 (0)	204/501 (40.7)
Single vessel	59/172 (34.3)	0/20 (0)	55/200 (27.5)
Double vessel	66/172 (38.4)	0/20 (0)	71/200 (35.5)
More than three and triple vessels	47/172 (27.3)	0/20 (0)	54/200 (27.0)
Target vessel LM	36/877 (4.1)	25/629 (4.0)	7/320 (2.2)
Target vessel LAD	622/1018 (61.1)	418/649 (64.4)	249/483 (51.6)
Target vessel LCX	328/1018 (32.2)	199/649 (30.7)	155/483 (32.1)
Target vessel RCA	346/1018 (34.0)	234/649 (36.1)	164/483 (34.0)
B2/C lesions	346/609 (56.8)	0/0 (0)	333/615 (54.1)
Multivessel lesions	33/78 (42.3)	0/0 (0)	39/83 (47.0)
Multivessel intervention	244/773 (31.6)	215/629 (34.2)	62/201 (30.8)
Aspirin	1375/1491 (92.2)	622/738 (84.3)	802/822 (97.6)
Clopidogrel/Ticlopidine	1300/1385 (93.9)	541/629 (86.0)	807/822 (98.2)
β-blockers	1104/1491 (74.0)	495/738 (67.1)	630/822 (76.6)
ACEI/ARB	1045/1491 (70.1)	404/738 (54.7)	667/822 (81.1)
Glycoprotein IIb/IIIa inhibitors	89/350 (25.4)	0/20 (0)	101/380 (29.7)
DES	822/851 (96.6)	701/738 (95.0)	176/179 (98.3)

MI: Myocardial infarction; PCI: Percutaneous coronary intervention; CABG: Coronary artery bypass grafting; NSTE-ACS: Non-ST segment elevation acute coronary syndrome; STEMI: ST segment elevation myocardial infarction; LM: Left main; LAD: Left anterior descending; LCX: Left circumflex; RCA: Right coronary artery; ACEI: Angiotensin-converting enzyme inhibitor; ARB: Angiotensin receptor blockers; DES: Drug-eluting stent.

Table 3 Assessment of randomized controlled trials

Ref.	Randomization sequence generation	Allocation concealment	Blinding of participants, personnel and outcome assessors	Incomplete outcome data	Selective reporting	Other sources of bias
Liu et al[10], 2016	Low risk	Low risk	High risk	Unclear risk	Unclear risk	Unclear risk
Jiao et al[11], 2015	Unclear risk	Unclear risk	Unclear risk	High risk	Unclear risk	Unclear risk
Jiao et al[12], 2015	Low risk	Low risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk
Zheng et al[7], 2015	Unclear risk	Unclear risk	High risk	Low risk	Low risk	Unclear risk
Xie et al[13], 2014	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk
Luo et al[14], 2013	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk
Wang et al[15], 2013	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk
Li et al[16], 2013	Low risk	Low risk	Low risk	Unclear risk	Unclear risk	Unclear risk
Gao et al[17], 2012	Unclear risk	Unclear risk	High risk	Unclear risk	Unclear risk	Unclear risk
Li et al[18], 2012	Unclear risk	Unclear risk	Low risk	Unclear risk	Unclear risk	Unclear risk
Yu et al[19], 2011	Unclear risk	Unclear risk	Unclear risk	High risk	Unclear risk	Unclear risk