Effects of loading dose of atorvastatin before percutaneous coronary intervention on periprocedural myocardial injury

Yu, Xing; Zhang, Hai Juan; Ren, Shao Da; Geng, Jing; Wu, Ting; Chen, Wen Qiang; Xiao, Ji; Zhong, Lin; Ge, Zhi

doi:10.1097/mca.0b013e328341baee

Cited by 28 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the NAPLES II trial showed that a single loading dose of atorvastatin (80 mg) within 24 h before PCI was effective in improving inhospital CV outcome (OR 0Á56 [CI 95% 0Á35-0Á89]; P = 0Á014), especially the recurrence of AMI (5% vs. 15%; P = 0Á04) in patients undergoing elective coronary angiography for symptomatic coronary artery disease [32]. More recently, several studies and a meta-analysis confirmed these findings, showing the effectiveness of a statin loading dose before PCI to improve short-term CV outcomes (RR 1Á08 [CI 95% 1Á02-1Á14]; P = 0Á01) [38,[40][41][42]. On the other hand, other clinical studies showed controversial results on this role for statins [28,30,34,36,37].…”

Section: Statin-associated Benefits In Patients Admitted For Acs Undesupporting

confidence: 58%

“…However, vascular injury following coronary angioplasty and stent displacement is still frequent and strongly worsen short-and longterm event-free survival [26]. Several studies reported that preoperative administration of statins might reduce the incidence of adverse effects after PCI [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] (Table 3). The Atorvastatin for Reduction of MYocardial Damage During Angioplasty-Acute Coronary Syndromes (ARMYDA-ACS) [29] and Novel Approaches for Preventing or Limiting Events (NAPLES) II trials [32] are the first large clinical trials supporting the use of a loading dose of atorvastatin (80 mg) before coronary PCI, to improve the short-term outcomes.…”

Section: Statin-associated Benefits In Patients Admitted For Acs Undementioning

confidence: 99%

See 1 more Smart Citation

Update on the efficacy of statin treatment in acute coronary syndromes

Rosa

Carbone

Parodi

et al. 2014

Eur J Clin Investigation

View full text Add to dashboard Cite

Background The natural history of atherosclerosis might involve coronary plaque rupture/erosion, thrombus formation and vessel lumen occlusion, clinically recognized as acute coronary syndrome (ACS). International guidelines strongly recommend early statin administration in patients admitted for ACS. In addition to lowering circulating levels of low-density lipoprotein cholesterol (LDL-c), statin treatment was shown to promote plaque stabilization or regression in several ways, including reduction in necrotic lipid core, anti-inflammatory effects and improvement in endothelial function. The aim of this review is to summarize clinical evidence on the role of statins in secondary prevention of ACS.

show abstract

Section: Statin-associated Benefits In Patients Admitted For Acs Undesupporting

confidence: 58%

Section: Statin-associated Benefits In Patients Admitted For Acs Undementioning

confidence: 99%

Update on the efficacy of statin treatment in acute coronary syndromes

Rosa

Carbone

Parodi

et al. 2014

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Yu and colleagues 18 reported the highest incidence of AST/ALT and CK elevations; however, these incidences were similar between statin and placebo groups. 26 The remainder of the studies either did not report or stated that no adverse effects attributable to statins were seen.…”

Section: Discussionmentioning

confidence: 98%

“…32 On the basis of the available evidence, all statin-naive patients (both ACS and stable angina) should be strongly recommended to receive statin-loading doses before PCI to reduce the incidence of PMI. [17][18][19][20][21][24][25][26] For patients on chronic statin therapy before PCI, strong consideration should be given to reload with statins, particularly if they present with ACS. 27 There is less evidence for patients on chronic statin therapy presenting with stable angina; however, because of the low risk associated with statin loading, it is reasonable to reload all patients on chronic statin therapy.…”

Section: Discussionmentioning

confidence: 99%

Statin Loading Before Percutaneous Coronary Intervention to Reduce Periprocedural Myocardial Infarction

Norris¹,

Anderson²

2012

Cardiology in Review

View full text Add to dashboard Cite

Periprocedural myocardial infarction (PMI) is a common complication associated with percutaneous coronary intervention (PCI), occurring in approximately 15% to 20% of patients undergoing the procedure. The established diagnostic criteria for PMI is an increase in cardiac biomarkers, specifically creatine kinase-MB levels > 3 times the upper limit of normal. As PMI has been associated with an increased risk of mortality after PCI, investigative efforts have been directed at therapies that can potentially decrease PMI. One such therapy is the use of hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) administered as a loading dose before PCI. Multiple small, randomized, controlled trials have demonstrated significant reductions in the incidence of PMI with statin loading before PCI. The risk reduction was seen in patients with stable and unstable coronary artery disease, as well in statin-naive patients or those on chronic statin therapy. Potential mechanisms for the rapid benefits of statin loading include: anti-inflammatory effects, reversal of endothelial dysfunction, decrease in oxidative stress, and inhibition of the thrombotic system. None of the current studies were of sufficient power or duration to detect benefits on mortality, though a recent meta-analysis did demonstrate a reduction in major adverse cardiovascular events. In addition to long-term effects, several additional questions remain with regard to statin loading, such as statin type, dose, and optimal timing of administration. However, given the current evidence of benefit and the low risk of adverse events, it can be recommended that all patients undergoing PCI be considered for statin loading before the procedure.

show abstract

“…[1][2][3][4][5][6][7][8] Importantly, PCI itself causes an acute vascular and systemic inflammatory response, which is diminished by potent preprocedural antiplatelet (glycoprotein IIb/IIIa inhibitors, clopidogrel, and other P2Y12 inhibitors) and statin therapy. [9][10][11][12] Hence, periprocedural hsCRP monitoring could be of use in identifying high-risk patients and guiding adjunctive periprocedural therapy to improve PCI outcomes.…”

mentioning

confidence: 99%

High Sensitivity C-Reactive Protein and Outcomes Following Percutaneous Coronary Intervention in Contemporary Practice

Herrmann

Lennon

Barsness

et al. 2012

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Background-High sensitivity C-reactive protein (hsCRP) has been identified as a predictor of adverse cardiovascular outcomes. Whether hsCRP is a useful biomarker for risk stratification in contemporary percutaneous coronary intervention remains unknown. Methods and Results-We conducted a prospective study among 513 patients undergoing non-emergency percutaneous coronary intervention and examined the relationship between pre-and postprocedural hsCRP levels and outcomes. The patients were divided according to the median preprocedural hsCRP level (0.3 mg/dL

show abstract

Effects of loading dose of atorvastatin before percutaneous coronary intervention on periprocedural myocardial injury

Abstract: Short-term pretreatment with a high dose of atorvastatin significantly reduces procedural myocardial injury in early PCI.

Cited by 28 publications

References 0 publications

Update on the efficacy of statin treatment in acute coronary syndromes

Update on the efficacy of statin treatment in acute coronary syndromes

Statin Loading Before Percutaneous Coronary Intervention to Reduce Periprocedural Myocardial Infarction

High Sensitivity C-Reactive Protein and Outcomes Following Percutaneous Coronary Intervention in Contemporary Practice

Contact Info

Product

Resources

About