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Published on: May 28, 2019
Prevention of peri-procedural myocardial injury using a single high loading dose of rosuvastatin
Serkan Cay1, Goksel Cagirci, Nihat Sen
1Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey. cayserkan@yahoo.com
Insights
A single high dose of rosuvastatin significantly reduced myocardial injury during PCI. This statin therapy effectively lowered biomarkers of cardiac damage, decreasing necrosis and infarction rates in patients undergoing the procedure.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Statins possess non-lipid-lowering, pleiotropic effects.
- Pre-procedural atorvastatin administration is linked to reduced peri-procedural myocardial injury.
Purpose of the Study:
- To evaluate the impact of a single high loading dose (40 mg) of rosuvastatin on peri-procedural myocardial injury.
Main Methods:
- 299 statin-naive patients with stable angina undergoing PCI were randomized.
- Patients received either a 40 mg rosuvastatin loading dose 24 hours before PCI or no treatment.
- Cardiac biomarkers (CK-MB and cTnI) were measured pre-procedure and 12 hours post-procedure.
Main Results:
- Rosuvastatin significantly reduced the incidence of CK-MB and cTnI elevation above 3x ULN (0.7% vs. 11.0% and 10.5% vs. 39.0%, respectively).
- Any elevation of CK-MB and cTnI above ULN was significantly lower in the rosuvastatin group (10.5% vs. 34.2% and 20.9% vs. 61.6%, respectively).
- Post-procedure CK-MB and cTnI levels were significantly lower in the rosuvastatin group compared to controls.
Conclusions:
- A single high loading dose of rosuvastatin effectively reduces peri-procedural myocardial necrosis.
- Rosuvastatin administration significantly lowers the incidence of myocardial infarction following PCI.
Background:
Extensively used lipid-lowering statins have also non-lipid-lowering, pleiotropic effects. Previous studies have demonstrated that a pre-procedural single dose of atorvastatin is associated with reduced peri-procedural myocardial injury.
Aim:
The aim of the present study was to demonstrate the effect of a single high loading dose (40 mg) of rosuvastatin on peri-procedural myocardial injury.
Methods:
Two hundred ninety nine statin-naive patients with stable angina and de novo lesions eligible for PCI were randomized to a rosuvastatin-treatment (n = 153) and to a no-treatment (n = 146) group. A 40 mg loading dose of rosuvastatin was administrated 24 h before the PCI. CK-MB and cTnI levels were measured before and 12 h after the procedure.
Results:
Baseline characteristics were fairly similar between the two arms. The incidence of a CK-MB and cTnI elevation >3x ULN in the rosuvastatin group was significantly lower compared to the control group (0.7% vs. 11.0%, p < 0.001 and 10.5% vs. 39.0%, p < 0.001, respectively). Similarly, the incidence of any CK-MB and cTnI elevation > ULN in the rosuvastatin group was significantly lower compared to the control group (10.5% vs. 34.2%, p < 0.001 and 20.9% vs. 61.6%, p < 0.001, respectively). In addition, CK-MB and cTnI values 12 h after the PCI were significantly lower in the rosuvastatin group compared to the control group (20.13 +/- 7.24 U/L vs. 27.02 +/- 18.64 U/L, p < 0.001 and 0.14 +/- 0.34 ng/ml vs. 0.35 +/- 0.40 ng/ml, p < 0.001, respectively).
Conclusion:
A single high loading dose of rosuvastatin reduces the incidence of peri-procedural myocardial necrosis and infarction effectively.
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