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Published on: May 14, 2013
Rosuvastatin versus atorvastatin to prevent contrast induced nephropathy in patients undergoing primary percutaneous
Ahmet Kaya1, Mustafa Kurt, Ibrahim Halil Tanboğa
1Dept. of Cardiology, Ordu University Medical School, Ordu, Turkey. drkayaahmet69@gmail.com
Insights
Atorvastatin and rosuvastatin showed similar effectiveness in preventing contrast-induced nephropathy (CIN) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (p-PCI). The amount of contrast agent was the main predictor of CIN.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI).
- Statins are frequently used peri-procedurally to mitigate CIN risk.
- Atorvastatin and rosuvastatin are commonly prescribed statins with differing pharmacokinetic profiles.
Purpose of the Study:
- To compare the incidence of CIN between high-dose atorvastatin and rosuvastatin in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI.
- To identify predictors of CIN in this patient population.
Main Methods:
- A randomized controlled trial involving 192 STEMI patients undergoing primary PCI.
- Patients received either atorvastatin 80 mg or rosuvastatin 40 mg prior to the procedure.
- Renal function was assessed at baseline and 48 hours post-procedure.
Main Results:
- The overall incidence of CIN was 8.9%.
- No statistically significant difference in CIN incidence or renal dysfunction markers was observed between the atorvastatin and rosuvastatin groups.
- The volume of contrast agent administered was the sole independent predictor of CIN (OR 1.08, 95% CI 1.03-1.13, P<0.001).
Conclusions:
- High-dose atorvastatin and rosuvastatin demonstrate comparable efficacy in preventing CIN in STEMI patients undergoing primary PCI.
- Contrast volume is a critical factor influencing CIN development, independent of statin choice.
Aim:
We aimed to compare the incidence of contrast-induced nephropathy (CIN) between atorvastatin versus rosuvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary coronary angioplasty.
Methods:
One hundred ninety-two consecutive patients, who underwent primary percutaneous intervention (p-PCI) with the diagnosis of STEMI, were included in the study. The patients were randomized to take atorvastatin 80 mg (n=98) or rosuvastatin 40 mg (n= 94) before the procedure. Biochemical and complete blood count measurements were done at baseline and at 48 hours following admission.
Results:
The incidence of CIN was 8.9% (n= 17) in the entire groups. The analysis performed between the statin groups revealed no statistical difference in any of the renal dysfunction indicators [baseline creatinine, baseline estimated glomerular filtration rate (eGFR), creatinine at 48 h, eGFR at 48 h, difference between baseline and 48 h creatinine, the per cent increase in the creatinine at 48 hours relative to basal creatinine]. In STEMI patients undergoing primary PCI, only the amount of the contrast agent administered was determined to be an independent predictor for CIN (OR and 95% CI: 1.08 (1.03- 1.13), P< or = 0.001). Left ventricular ejection fraction exhibited borderline statistical significance (OR and 95% CI: 0.88 (0.77-1.01), P= 0.07).
Conclusion:
Atorvastatin and rosuvastatin had similar efficacy in preventing CIN in patients with STEMI undergoing P-PCI.
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