Related Experiment Video
Updated: May 13, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Comparative Efficacy of High-Dose Rosuvastatin and Atorvastatin in Preventing Cystatin C-Oriented Contrast-Induced
Ji Hye Kim1, Hyunah Kim2, Seung-Hyuk Choi3
1Division of Nephrology, Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Insights
High-dose rosuvastatin and atorvastatin showed no significant difference in preventing contrast-induced nephropathy (CIN) in acute myocardial infarction (AMI) patients. Cystatin C (cysC) proved more sensitive for early CIN detection than creatinine.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Contrast-induced nephropathy (CIN) is a significant risk in acute myocardial infarction (AMI) patients undergoing interventions.
- High-dose statins are explored for CIN prevention, but direct comparisons using cystatin C (cysC) are lacking.
- This study compares high-dose rosuvastatin and atorvastatin for cysC-based CIN prevention in AMI.
Purpose of the Study:
- To evaluate the efficacy of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN in AMI patients.
- To compare the incidence of cysC-CIN and creatinine-based CIN (cr-CIN) between the two statin groups.
- To assess 30-day adverse renal, cardiovascular, and mortality events.
Main Methods:
- A multicenter registry study involving 431 AMI patients.
- Patients received either high-dose rosuvastatin (20 mg, n=231) or atorvastatin (40 mg, n=200).
- Primary endpoint: cysC-CIN incidence within 48 hours; Secondary endpoints: cr-CIN incidence within 72 hours and 30-day adverse events.
Main Results:
- No statistically significant difference in cysC-CIN (12.1% vs. 7.5%, P=0.103) or cr-CIN (6.2% vs. 3.5%, P=0.103) incidence between groups.
- Multivariable analysis showed no increased odds of cysC-CIN with atorvastatin (OR, 2.185; P=0.085).
- However, statin-naïve patients on atorvastatin had significantly higher cysC-CIN odds (OR, 2.977; P=0.039). 30-day outcomes were similar.
Conclusions:
- High-dose rosuvastatin and atorvastatin demonstrated comparable effectiveness in preventing cysC-CIN in AMI patients.
- Cystatin C is a more sensitive biomarker for early detection of CIN compared to creatinine.
- Further research may be needed for statin-naïve subgroups.
Background:
Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients.
Methods:
This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events.
Results:
The incidences of cysC-CIN (12.1% vs. 7.5%, P = 0.103) and cr-CIN (6.2% vs. 3.5%, P = 0.103) were higher in the atorvastatin group without significant statistical differences. Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; P = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; P = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups.
Conclusion:
No significant difference in cysC-CIN incidence was found between the high-dose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.
Trial Registration:
Clinical Research Information Service Identifier: KCT0003703.
More Related Videos
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
04:41Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
01:22Dose-Response Relationship: Potency and Efficacy
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors