Randomized controlled trials that comparing pre-procedural statins with placebo in patients undergoing percutaneous coronary interventions were eligible for inclusion. Studies had to report peri-procedural myocardial infarction as an outcome and define myocardial infarction events.
Most of the included trials (four out of six) were of atorvastatin and used differing dosing schedules. One trial used rosuvastatin. One trial used a variety of statins and dosing regimens.
Four trials reported peri-procedural myocardial infarction as the primary outcome measure; one specified large non-Q-wave myocardial infarction; and one reported 30-day major adverse cardiac events. Peri-procedural myocardial infarction was defined by the included trials as post-procedural elevation in creatine kinase-MB isoenzyme (various thresholds), alone or in combination with chest pain and/or ST-segment or T-wave abnormalities. Other outcomes of interest were: one-month mortality; non peri-procedural myocardial infarction; target vessel revascularisation; by-pass surgery or repeat percutaneous coronary interventions of the target vessel; and composite outcomes.
The mean age of participants in included trials ranged from 62 to 68 years; the proportion of males ranged from 54 to 88%. Treatment and placebo groups were similar at baseline for diabetes mellitus, hypercholesterolaemia, and use of platelet IIb/IIIa antagonist.
Two reviewers independently assessed studies for inclusion.