LAUSR

BACKGROUND Carotid artery endarterectomy (CEA) remains the most common surgical intervention for the treatment of symptomatic and asymptomatic carotid artery stenosis. Several studies have shown a lower risk of periprocedural adverse events in statin users who undergo coronary interventions or carotid artery stenting. The aim of this meta-analysis was to determine whether the use of statins is beneficial in patients undergoing CEA. METHODS This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were identified through a search of PubMed, Scopus, and Cochrane until August 2017. A random effects model meta-analysis was conducted and the I2 statistic was used to assess for heterogeneity. RESULTS Six studies and 7053 patients overall were included. Thirty days after CEA, 157 (2.2%) patients had a stroke (1.4% in the statin-user group vs. 3% in the statin-naïve group). Despite the difference in the absolute rate of stroke, there was no statistically significant difference in the 30-day stroke rate (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.15-1.09; I2 = 75.6%). Overall, 141 (2%) patients suffered 30-day myocardial infarction, with no significant difference between the 2 groups (OR 0.77; 95% CI 0.26-2.24; I2 = 77%). Patients who received statins before CEA were at a significantly lower risk for 30-day death (OR 0.26; 95% CI 0.10-0.61; I2 = 17.7%). CONCLUSIONS Statin users undergoing CEA were at a significantly lower risk for periprocedural death compared with statin-naïve patients. Despite an absolute difference in the stroke rate, the current meta-analysis did not detect a statistically significant difference in the 30-day stroke rate between statin-user and statin-naïve patients undergoing CEA.