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Effectiveness of Statins in Treatment of Chronic Obstructive Pulmonary Disease Combining with Pulmonary Hypertension: A Meta-analysis / 医药导报
Herald of Medicine ; (12): 276-287, 2017.
Article in Chinese | WPRIM | ID: wpr-511310
ABSTRACT
Objective To systematically review the effectiveness and safety of statins for chronic obstructive pulmonary diseases (COPD) combining with pulmonary hypertension (PH).Methods The electronic searches in databases of PubMed,EMbase,the Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang Data were conducted from the date of their establishment to January 2016 and the references of the include studies were also retrieved for collecting randomized controlled trials (RCTs) or quasi-RCTs on statins treating COPD combining with PH.Two researchers independenlty screened the literature according to the inclusion and exclusion criteria,extracted the data,assessed the quality of the included studies by adopting the Cochrane collaboration' s tool for assessing risk of bias,and performed Meta-analysis by using RevMan 5.3 software.Results A total of 24 studies involving 1 587 cases were included.The results of Meta-analysis showed thatcompared with the control group,simvastatin significantly improved FEV1 [MD =0.23,95% CI0.16-0.31,P < 0.000 01],FEV1 % [MD =6.73,95% CI1.34-12.12,P =0.01],FVC [MD =0.39,95% CI0.34-0.45,P < 0.000 01],6 minutes walk distance (6MWD)· [MD=59.09,95%CI54.24-63.93,P <0.000 01] and decreased mPAP [MD=6.73,95% CI1.34-12.12,P =0.01],SPAP [MD =-4.53,95 % CI =-8.87--0.19,P =0.04].Atorvastatin significantly improved FEV1 [MD =6.22,95 % CI2.51-9.93,P =0.001] and 6 MWD [MD =24.10,95 % CI12.98-35.23,P < 0.000 1] and decreased sPAP [MD =-6.44,95%CI-7.95--4.93,P<0.00001] andmPAP [MD=-3.51,95%CI-5.81--1.22,P=0.003].But no significant difference was found in the improvement of FEV1,FVC or FEV1/FVC.Fluvastatin significantly decreased sPAP [MD=-5.89,95% CI-6.99--4.79,P <0.000 01].There was a significant decrease in the Borg dyspnoea score in statins group [MD =-3.37,95% CI-4.61--2.14,P < 0.000 01] as compared with the controls.In addition,the incidence of adverse drug reactions (ADRs) was similar between statins and the control group.Conclusion Current evidence suggests that statins may decrease pulmonary hypertension in patients with COPD combining with PH.However,high-quality clinical trials with large sample size are needed to verify whether the improvement of pulmonary function,6MWD and Borg dyspnoea score are the class effect or the incidence of ADRs is disparate among different statins.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Systematic reviews Language: Chinese Journal: Herald of Medicine Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Systematic reviews Language: Chinese Journal: Herald of Medicine Year: 2017 Type: Article