Abstract

Background

Given the complex aetiology and a limited amount of evidence, the medical treatment (including statin use) of myocardial infarction with non-obstructive coronary artery disease (MINOCA) remains uncertain. The objective of the present study was to evaluate the effect of statin therapy on major cardiovascular events (MACE) and mortality in MINOCA patients.

Methods

A systematic review and meta-analysis of time-to-event outcomes were performed of studies of statin therapy on MINOCA patients, reporting data from MACE or mortality, after searching the PubMed/MEDLINE, Embase, Science Direct, Scopus, Google Scholar, and Cochrane databases. A fixed-effects meta-analysis model was then applied.

Results

Six observational studies of statin therapy on MINOCA, involving a total of 11,171 patients, were identified and considered eligible for analysis (9129 subjects received statin therapy while 2042 patients were part of the respective control arms). Quantitative analysis (5 studies were included) showed that statin use was associated with lower mortality (HR: 0.65; 95% CI: 0.56–0.75, I²: 0%). Also, the meta-analysis showed that statin therapy was associated with a lower incidence of MACE (HR: 0.78; 95% CI: 0.69–0.88, I²:27%).

Conclusion

Our data suggest that in a population with MINOCA, the use of statin therapy results in significant reduction on MACE and mortality. These results must be confirmed in future clinical trials.

中文翻译：

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他汀类药物治疗对非阻塞性冠状动脉心肌梗死 (MINOCA) 患者的预后价值：一项荟萃分析

摘要

背景

鉴于复杂的病因和有限的证据，心肌梗死合并非阻塞性冠状动脉疾病 (MINOCA) 的药物治疗（包括他汀类药物的使用）仍不确定。本研究的目的是评估他汀类药物治疗对 MINOCA 患者主要心血管事件 (MACE) 和死亡率的影响。

方法

在搜索 PubMed/MEDLINE、Embase、Science Direct、Scopus、Google Scholar 和Cochrane 数据库。然后应用固定效应荟萃分析模型。

结果

六项针对 MINOCA 的他汀类药物治疗的观察性研究，共涉及 11,171 名患者，被确定并认为符合分析条件（9129 名受试者接受他汀类药物治疗，而 2042 名患者属于各自的对照组）。定量分析（纳入 5 项研究）表明他汀类药物的使用与较低的死亡率相关（HR：0.65；95% CI：0.56–0.75，I ²：0%）。此外，荟萃分析显示，他汀类药物治疗与较低的 MACE 发生率相关（HR：0.78；95% CI：0.69–0.88，I ²：27%）。

结论

我们的数据表明，在患有 MINOCA 的人群中，使用他汀类药物治疗可显着降低 MACE 和死亡率。这些结果必须在未来的临床试验中得到证实。