Prognostic value of statin therapy in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA): a meta-analysis

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, I 2: 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, I 2:27%). 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.