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A decline in kidney function after contrast exposure is associated with a high risk of morbidity and mortality during hospitalization and over long-term periods. Several retrospective and recent prospective clinical trials have shown that statin therapy might prevent contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. In this study, we aimed to assess the effects of statin therapies on renal function parameters in patients undergoing elective coronary angiography. One hundred and sixty patients undergoing elective coronary angiography were randomized equally into two groups: atorvastatin 40 mg/day group (statin started 3 days before coronary angiography) and an untreated control group. An additional 80 patients were included as a chronic statin therapy group. Serum creatinine, serum cystatin C, and glomerular filtration rate (GFR) were measured before and 48 h after coronary angiography. Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations were used to determine GFR. After coronary angiography, serum creatinine and GFR determined by MDRD were significantly better in patients using atorvastatin than those in controls (P = 0.002 and P = 0.004, respectively). Postprocedure serum creatinine, cystatin C, and GFR determined by MDRD were also significantly better in chronic statin therapy group than those in controls (P = 0.006, P = 0.003, and P = 0.004, respectively). There were no differences in renal function parameters between the short-term atorvastatin group and the chronic statin therapy group. Our data demonstrate that the use of short-term atorvastatin and chronic statin therapy may have a role in protecting renal function after elective coronary angiography.

INTRODUCTIONWith an increasing number of coronary angiography (CAG) procedures, coronary invasive procedures and cardiac bypass surgeries performed each day, knowledge of the variations, anomalies and anatomical pattern of coronary arteries is gaining in importance. Although many individuals have a normal coronary anatomy, variations and anomalies are not unusual, and may lead to complications during procedures. (1) There are two main coronary arteries that supply oxygenated blood to the myocardium -the left main coronary artery (LMCA) and the right coronary artery (RCA). The LMCA originates from the left sinus of Valsalva (SV), while the RCA originates from the right SV. There is typically no artery arising from the posterior SV. The LMCA bifurcates into the left anterior descending (LAD) artery and the circumflex artery (CXA). An additional artery called the intermediate artery (IMA) may arise at the bifurcation of the LMCA, forming a trifurcation.The LAD artery runs in the anterior interventricular sulcus, providing the penetrating septal branches. The left CXA runs along the left atrioventricular sulcus and gives rise to at least one obtuse marginal (OM) branch, while the RCA lies in the right atrioventricular sulcus and gives rise to the acute marginal branch. The IMA, which supplies the left ventricular free wall, is located anterior to the first OM artery and posterior to the first diagonal artery. It can also originate from the proximal part of the LMCA, LAD artery or CXA. In some cases, it is not possible to distinguish between the IMA and OM artery using anatomical or angiographic examinations. However, an important point of distinction is that the left ventricular free wall is supplied by the IMA.(1-3)The artery that supplies the posterior descending artery determines coronary dominance. Approximately 70%-80% of the general population is right-dominant (i.e. supplied by the RCA), while 5%-10% is left-dominant (i.e. supplied by the CXA) and 10%-20% is co-dominant (i.e. supplied by both the RCA and CXA).(3-5) A more accurate definition of dominance refers to the arterial supply to the atrioventricular nodal artery, which is generally supplied by the RCA. (3)(4)(5) Typically, there are two coronary ostia. However, in some cases where the LMCA is absent, three ostia can be detected.In individuals with such a condition, the LAD artery and CXA originate from different ostia. Absence of the LMCA is a common anomaly that can be detected in 0.4%-8% of the population. (4,5) Coronary arteries can be anatomically categorised into three groups based on their anatomical features: normal coronary anatomy, anatomic variations of the coronary artery and coronary artery anomalies (CAAs). CAAs, which are congenital disorders in the coronary anatomy that are observed in less than 1% of the general population, are evaluated using CAG series.

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