Effects Of Statins On The Prognosis Of Coronary Artery Spasm:A Meta-Analysis

Objective:Previous guidelines for the diagnosis and treatment of coronary artery spasm recommended the use of statins to reduce the frequency of coronary spasm,however,several recent observational studies have failed to confirm the effectiveness of statins.This study collected relevant literature on the treatment of coronary artery spasm with statins for Meta-analysis,aiming to explore whether statins can improve the prognosis of patients with coronary artery spasm.Methods:Eight well-known databases were searched(the deadline was October 31,2021),and literatures that met the inclusion criteria were selected.Literature publication bias assessment was performed using funnel plots.Corresponding scales were used to evaluate the quality of the literature according to the type of study.Data statistics and analysis were performed using RevMan5.3 software.The count data were analyzed with odds ratio and 95%confidence interval from the incidence of major adverse cardiovascular events,myocardial infarction,and sudden cardiac death in the included studies.Results:1.A total of 7 studies were included,with a total of 7206 patients with coronary artery spasm,including 3813 in the statin group and 3393 in the non-statin group.2.The overall study showed that compared with the non-statin group,the statin group did not reduce the risk of major adverse cardiovascular events(MACE)[OR=0.65,95%CI(0.39,1.09),P=0.10].Included studies included observational studies,randomized controlled studies,and subgroup analyses by study type.Subgroup analysis of observational studies showed that there was no significant difference in the incidence of major adverse cardiovascular events between the statin group and the non-statin group[OR=0.76,95%CI(0.44,1.73),P=0.34].Two of the observational studies were assigned a preference,and the conclusions were relatively reliable after excluding other confounding factors.The analysis of 2 randomized controlled studies and 2 propensity assignment studies showed that there was no significant difference in the incidence of major adverse cardiovascular events between the statin group and the non-statin group[OR=0.42,95%CI(0.17,1.01),P=0.05].3.The subgroup analysis of myocardial infarction and sudden cardiac death showed that there was no significant difference in the incidence of myocardial infarction between the statin group and the non-statin group[OR=0.63,95%CI(0.27,1.50),P=0.30];There was no significant difference in the incidence of sudden cardiac death between the statin group and the non-statin group[OR=0.84,95%CI(0.58,1.21),P=0.34].Conclusion:Statins had no significant effect on the incidence of major adverse cardiovascular events in patients with coronary artery spasm,nor did they reduce the incidence of myocardial infarction and sudden cardiac death.