Effects of statin therapy on augmentation index as a measure of arterial stiffness: A systematic review and meta-analysis

•First meta-analysis examining the influence of statin therapy on augmentation index•18 trials examining the effects of statin therapy on arterial stiffness included•A significant reduction in aortic AIx following statin therapy was proven.•The impact of statins on AIx was independent of LDL-cholesterol level.

ObjectiveTo evaluate the effects of statin therapy on augmentation index (AIx) as a measure of arterial stiffness using a meta-analysis of clinical trials.MethodsThe search included PubMed-Medline, Embase, SCOPUS, Web of Science and Google Scholar databases to identify randomized controlled trials investigating the effects of statin therapy on arterial stiffness measured as AIx. A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Random-effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential confounders.Results18 trials examining the effects of statin therapy on arterial stiffness were included. A significant reduction in aortic AIx following statin therapy was proven (WMD: − 2.40%, 95% CI: − 4.59, − 0.21, p = 0.032; I2: 51.20%). HR-adjusted AIx 75% values also revealed a significant improvement by statin therapy (WMD: − 5.04%, 95% CI: − 7.81, − 2.27, p < 0.001; I2: 0%), but not when analysis was restricted to unadjusted AIx values (WMD: − 2.30%, 95% CI: − 4.83, 0.23, p = 0.075; I2: 53.83%). There was no significant change in carotid (WMD: − 2.75%, 95% CI: − 8.06, 2.56, p = 0.309; I2: 26.86%) and peripheral (WMD: 0.25%, 95% CI: − 3.31, 3.82, p = 0.889; I2: 72.19%) AIx due to statin treatment. There was also no difference in the effect size calculated for different statins subgroups. The impact of statins on AIx was independent of LDL-cholesterol level (slope: 0.05; 95% CI: − 0.02, 0.13; p = 0.181).ConclusionStatin therapy causes a significant reduction in aortic AIx which is independent of LDL-cholesterol changes.