Atorvastatin Protects Against Heart Attack

Short-term high-dose atorvastatin administration reduced peri-procedure MI in patients with renal dysfunction submitted to elective PCI, but without benefit regarding Contrast Induced Nephropathy prevention.

Amplify’d from www.ncbi.nlm.nih.gov
J Cardiovasc Med (Hagerstown). 2011 May;12(5):318-21.

Short-term high-dose atorvastatin for periprocedural myocardial infarction prevention in patients with renal dysfunction.

Source

Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. anna.toso@libero.it

Abstract

OBJECTIVES:

Short-term high-dose atorvastatin administered before percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (pMI) in high-risk patients, such as those with acute coronary syndromes and those with elevated high-sensitivity C-reactive protein. It is unknown whether short-term high-dose administration reduces the rate of pMI in patients with chronic kidney disease. Recently, we observed that in 304 patients with estimated creatinine clearance less than 60 ml/min randomized to receive 80 mg/day of atorvastatin or placebo for 48 h before elective coronary angiography and/or angioplasty, statin administration did not reduce contrast-induced nephropathy (CIN). In this post-hoc analysis, we evaluate the pMI in the subgroup of 161 patients who underwent PCI.

METHODS:

In all patients, creatine kinase myocardial isoenzyme (CK-MB) [upper reference limit (URL) 5 ng/ml] was assessed before and at 12 and 24 h after PCI. The pMI, defined as CK-MB elevation more than three times the URL, occurred in 27 (17%) patients.

RESULTS:

The incidence of pMI was 10.4% (of 77 patients) in the atorvastatin and 23% (of 84 patients) in the placebo group (P < 0.05). Multivariate analysis identified the pretreatment with high-dose atorvastatin as an independent predictor of reduced risk of pMI [odds ratio 0.39, 95% confidence interval 0.16-0.96, P < 0.05].

CONCLUSION:

This post-hoc analysis shows that short-term high-dose atorvastatin administration reduced pMI in patients with renal dysfunction submitted to elective PCI, but without benefit regarding CIN prevention.

Read more at www.ncbi.nlm.nih.gov

 

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