OBJECTIVES:Atorvastatin administered at least 7 days before the percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (MI). It is unknown whether a single, high (80 mg) loading dose of atorvastatin may reduce the rate of periprocedural MI. BACKGROUND:Periprocedural MI is a prognostically important complication of PCI. METHODS: The day before the elective PCI, 668 statin-naive patients were randomly assigned to atorvastatin 80 mg (atorvastatingroup; n = 338) orno statin treatment (control group; n = 330). Creatine kinase-myocardial isoenzyme (CK-MB) (upper limit of normal [ULN] 3.5 ng/ml) and cardiac troponin I (ULN 0.10 ng/ml) were assessed before and 6 and 12 h after the intervention. Periprocedural MI was defined as a CK-MB elevation >3x ULN alone or associated with chest pain or ST-segment or T-wave abnormalities. RESULTS: The incidence of a periprocedural MI was 9.5% in the atorvastatin group and 15.8% in the control group (odds ratio: 0.56; 95% confidence interval: 0.35 to 0.89; p = 0.014). Median CK-MB peak after PCI was 2.10 ng/ml (interquartile range 1.00 to 12.50 ng/ml) in the atorvastatin group and 3.20 ng/ml (interquartile range 1.37 to 16.07 ng/ml) in the control group (p = 0.014). The incidence of cardiac troponin I elevation >3x ULN was 26.6% in the atorvastatin group and 39.1% in the control group (odds ratio: 0.56; 95% confidence interval: 0.40 to 0.78; p < 0.001). CONCLUSIONS: A single, high (80 mg) loading (within 24 h) dose of atorvastatin reduces the incidence of periprocedural MI in elective PCI.
RCT Entities:
OBJECTIVES:Atorvastatin administered at least 7 days before the percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (MI). It is unknown whether a single, high (80 mg) loading dose of atorvastatin may reduce the rate of periprocedural MI. BACKGROUND: Periprocedural MI is a prognostically important complication of PCI. METHODS: The day before the elective PCI, 668 statin-naive patients were randomly assigned to atorvastatin 80 mg (atorvastatin group; n = 338) or no statin treatment (control group; n = 330). Creatine kinase-myocardial isoenzyme (CK-MB) (upper limit of normal [ULN] 3.5 ng/ml) and cardiac troponin I (ULN 0.10 ng/ml) were assessed before and 6 and 12 h after the intervention. Periprocedural MI was defined as a CK-MB elevation >3x ULN alone or associated with chest pain or ST-segment or T-wave abnormalities. RESULTS: The incidence of a periprocedural MI was 9.5% in the atorvastatin group and 15.8% in the control group (odds ratio: 0.56; 95% confidence interval: 0.35 to 0.89; p = 0.014). Median CK-MB peak after PCI was 2.10 ng/ml (interquartile range 1.00 to 12.50 ng/ml) in the atorvastatin group and 3.20 ng/ml (interquartile range 1.37 to 16.07 ng/ml) in the control group (p = 0.014). The incidence of cardiac troponin I elevation >3x ULN was 26.6% in the atorvastatin group and 39.1% in the control group (odds ratio: 0.56; 95% confidence interval: 0.40 to 0.78; p < 0.001). CONCLUSIONS: A single, high (80 mg) loading (within 24 h) dose of atorvastatin reduces the incidence of periprocedural MI in elective PCI.
Authors: Otavio Berwanger; Eliana Vieira Santucci; Pedro Gabriel Melo de Barros E Silva; Isabella de Andrade Jesuíno; Lucas Petri Damiani; Lilian Mazza Barbosa; Renato Hideo Nakagawa Santos; Ligia Nasi Laranjeira; Flávia de Mattos Egydio; Juliana Aparecida Borges de Oliveira; Frederico Toledo Campo Dall Orto; Pedro Beraldo de Andrade; Igor Ribeiro de Castro Bienert; Carlos Eduardo Bosso; José Armando Mangione; Carisi Anne Polanczyk; Amanda Guerra de Moraes Rego Sousa; Renato Abdala Karam Kalil; Luciano de Moura Santos; Andrei Carvalho Sposito; Rafael Luiz Rech; Antônio Carlos Sobral Sousa; Felipe Baldissera; Bruno Ramos Nascimento; Roberto Rocha Corrêa Veiga Giraldez; Alexandre Biasi Cavalcanti; Sabrina Bernardez Pereira; Luiz Alberto Mattos; Luciana Vidal Armaganijan; Hélio Penna Guimarães; José Eduardo Moraes Rego Sousa; John Hunter Alexander; Christopher Bull Granger; Renato Delascio Lopes Journal: JAMA Date: 2018-04-03 Impact factor: 56.272
Authors: Binita Shah; Michael Pillinger; Hua Zhong; Bruce Cronstein; Yuhe Xia; Jeffrey D Lorin; Nathaniel R Smilowitz; Frederick Feit; Nicole Ratnapala; Norma M Keller; Stuart D Katz Journal: Circ Cardiovasc Interv Date: 2020-04-16 Impact factor: 6.546
Authors: Bernard R Chaitman; Regina M Hardison; Dale Adler; Suzanne Gebhart; Mary Grogan; Salvador Ocampo; George Sopko; Jose A Ramires; David Schneider; Robert L Frye Journal: Circulation Date: 2009-11-17 Impact factor: 29.690