Can a high reloading dose of atorvastatin prior to percutaneous coronary intervention reduce periprocedural...

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Periprocedural myocardial infarction (MI) is a frequent complication after percutaneous coronary intervention (PCI).
• Statins are known to reduce MI in statin-naïve patients undergoing PCI.
• The efficacy of high-dose atorvastatin reloading in patients already on statin therapy remains to be fully elucidated.

Purpose of the Study:

• To determine if a high reloading dose of atorvastatin can prevent periprocedural MI in patients already receiving statin therapy.
• To evaluate the impact of atorvastatin on cardiac biomarkers and inflammatory markers post-PCI.

Main Methods:

• A triple-blind, controlled, randomized clinical trial involving 190 patients undergoing elective PCI.
• Participants, already on statins or other lipid-lowering agents, were randomized to receive either 80 mg atorvastatin or placebo within 24 hours before PCI.
• Serum levels of CK-MB, cTNI, and hs-CRP were measured at baseline and at 6 and 12 hours post-PCI. MI was defined by specific troponin elevation criteria.

Main Results:

• The frequency of MI was significantly lower in the atorvastatin group (3.1%) compared to the placebo group (10.5%) (p=0.04).
• Atorvastatin significantly reduced the rise in CK-MB within 6 hours and cTNI levels at 6 and 12 hours post-PCI.
• High-sensitive C-reactive protein (hs-CRP) levels were significantly lower in the atorvastatin group 12 hours after PCI (p=0.004).

Conclusions:

• Administering a high reloading dose of atorvastatin within 24 hours before PCI significantly reduces the incidence of periprocedural MI.
• This strategy is effective in mitigating myocardial injury and inflammation in patients already on statin therapy undergoing PCI.
• Clinical Trial Registration Code: IRCT201205209768N1.