Mohamed Shehata1, Mohamed Hamza. 1. Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
INTRODUCTION: The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results. AIM: This study sought to evaluate the role of atorvastatin in prevention of CIN in diabetic patients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI). METHODS:130 patients with mean glomerular filtration rate of 48.5 ± 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 μmol/L) or >25% of baseline value was considered as CIN. RESULTS:Mean age of the study cohort was 56 ± 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05). CONCLUSION:Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabetic patients with CKD undergoing PCI.
RCT Entities:
INTRODUCTION: The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results. AIM: This study sought to evaluate the role of atorvastatin in prevention of CIN in diabeticpatients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI). METHODS: 130 patients with mean glomerular filtration rate of 48.5 ± 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 μmol/L) or >25% of baseline value was considered as CIN. RESULTS: Mean age of the study cohort was 56 ± 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05). CONCLUSION:Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabeticpatients with CKD undergoing PCI.
Authors: Edwin A Takahashi; David F Kallmes; Chad J Fleming; Robert J McDonald; Michael A McKusick; Haraldur Bjarnason; William S Harmsen; Sanjay Misra Journal: J Vasc Interv Radiol Date: 2017-09-22 Impact factor: 3.464
Authors: M Joannidis; W Druml; L G Forni; A B J Groeneveld; P M Honore; E Hoste; M Ostermann; H M Oudemans-van Straaten; M Schetz Journal: Intensive Care Med Date: 2017-06-02 Impact factor: 17.440