The effects and mechanisms of high loading dose rosuvastatin therapy before percutaneous coronary intervention in patients with acute coronary syndrome

Luo, Jun; Jiang, Li; Shen, Xiongjie; Hu, Xinqun; Fang, Zhenfei; Lv, Xinyi; Zhou, Shenghua

doi:10.1016/j.ijcard.2012.11.032

Cited by 16 publications

(26 citation statements)

References 15 publications

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“…This characteristic may underlie the protective effect of stenting treatment followed by subsequent local platelet recruitment. 43 Figures 6 and 7 reveal that significantly fewer platelets adhered to the drug-loaded stents, and the interaction of the two drugs in the stent system may have additively improved the adhesion of platelets. 14 BrdU assays revealed that the eluent promoted the proliferation (P0.05) of HUVACs over that in the control group on day 3.…”

Section: Test Of Adhesion Of Platelets To Des and Responses Of Cells mentioning

confidence: 99%

Promoting endothelial recovery and reducing neointimal hyperplasia using sequential-like release of acetylsalicylic acid and paclitaxel-loaded biodegradable stents

Lee¹,

Yu²,

Chang³

et al. 2014

IJN

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Introduction This work reports on the development of a biodegradable dual-drug-eluting stent with sequential-like and sustainable drug-release of anti-platelet acetylsalicylic acid and anti-smooth muscle cell (SMC) proliferative paclitaxel. Methods To fabricate the biodegradable stents, poly-L-lactide strips are first cut from a solvent-casted film. They are rolled onto the surface of a metal pin to form spiral stents. The stents are then consecutively covered by acetylsalicylic acid and paclitaxel-loaded polylactide-polyglycolide nanofibers via electrospinning. Results Biodegradable stents exhibit mechanical properties that are superior to those of metallic stents. Biodegradable stents sequentially release high concentrations of acetylsalicylic acid and paclitaxel for more than 30 and 60 days, respectively. In vitro, the eluted drugs promote endothelial cell numbers on days 3 and 7, and reduce the proliferation of SMCs in weeks 2, 4, and 8. The stents markedly inhibit the adhesion of platelets on days 3, 7, and 14 relative to a non-drug-eluting stent. In vivo, the implanted stent is intact, and no stent thrombosis is observed in the stent-implanted vessels without the administration of daily oral acetylsalicylic acid. Promotion of endothelial recovery and inhibition of neointimal hyperplasia are also observed on the stented vessels. Conclusion The work demonstrates the efficiency and safety of the biodegradable dual-drug-eluting stents with sequential and sustainable drug release to diseased arteries.

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Section: Test Of Adhesion Of Platelets To Des and Responses Of Cells mentioning

confidence: 99%

Promoting endothelial recovery and reducing neointimal hyperplasia using sequential-like release of acetylsalicylic acid and paclitaxel-loaded biodegradable stents

Lee¹,

Yu²,

Chang³

et al. 2014

IJN

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“…Only 27 articles were retained after screening the title and abstract. Finally, 12 studies involving 3183 patients were included in the present meta-analysis [7][8][9][10][11][12][13][14][15][16][17][18] . Among them, 1545 patients belonged to intensive statin treatment group and 1638 patients belonged to non-intensive statin treatment group.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

“…The baseline clinical, angiographic and procedural characteristics of patients are listed in Table 2. Quality assessment results were described in [ 11] 159 79/80 [ 14] 125 2012 [ 17] 161 There were 10 studies that compared the effects of preoperative intensive statin therapy and non-intensive statin therapy on the incidence of MACE and nonfatal MI respectively [7][8][10][11][12][13][14][15][16]18] . Due to the heterogeneity between different results, a random effects model was used.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

“…2b) between two groups were statistically significant. There were 9 studies that compared the effects of preoperative intensive statin therapy and non-intensive statin therapy on the incidence of cardiac death and target vessel revascularization [8,[10][11][12][13][14][15][16]18] . Considering the homogeneity between the results, a fixed effect model was used and both indicators were not statistically significant RR=0.37, 95%CI:0.01~8.96, p=0.54, Fig.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

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Intensive versus non-intensive statin pretreatment before percutaneous coronary intervention in Chinese patients: a meta-analysis of randomized controlled trials

Lan

Zhang

et al. 2020

Preprint

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Background: The results of intensive statin pretreatment before percutaneous coronary intervention (PCI) is inconsistent between Chinese and Western populations and there are no corresponding meta-analyses involving hard clinical end-points in the available published literature. The aim of this study was to evaluate the efficacy and safety of high-dose statin loading before PCI in Chinese patients through a meta-analysis. Method: Relevant studies were identified by searching the electronic databases of PubMed, Embase, and Cochrane’s Library to December 2019. The outcomes included an assessment of major adverse cardiovascular event (MACE), non-fatal myocardial infarction (MI), cardiac death, target vessel revascularization (TVR), myalgia/myasthenia and abnormal alanine aminotransferase (ALT) in all enrolled patients. Results: 12 studies involving 3,183 individuals were included．The results showed statistically significant different in the incidence of MACE (RR=0.49, 95% CI: 0.30-0.80, P=0.004, I2=63%) and non-fatal MI (RR=0.54, 95% CI: 0.33-0.88, P= 0.01, I2=62%) on comparing the intensive statin and non-intensive statin treatment groups. Subgroup analysis further suggested the benefits of different treatments were inconsistent. Compared with preoperative intensive statin therapy, the incidence of MACE and non-fatal MI were significantly elevated in patients receiving placebo or no statin treatment before surgery (RR=0.47, 95% CI: 0.34-0.65, P<0.00001, I2=0%; RR=0.49, 95% CI: 0.35-0.70, P<0.0001, I2=0%). However, the incidence of MACE and non-fatal MI were not statistically significant when comparing preoperative high-intensity statin therapy with moderate-intensity statin therapy (RR=0.96, 95% CI: 0.44-2.08, P=0.91, I2=11%; RR=1.10, 95% CI: 0.86-1.39, P=0.44). The study also demonstrated that the Asian population could tolerate high-intensity atorvastatin during the perioperative period. Conclusion: Compared with placebo or no statin pretreatment, Chinese patients receiving intensive statin therapy before PCI displayed reduced incidence of MACE and non-fatal MI. However, there was no significant benefit between high-intensity and moderate-intensity statin treatment. Further, the Chinese population tolerated well preoperative intensive statin pretretment.

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“…Multivariate analysis revealed that rosuvastatin loading was an independent predictor of a reduction in the risk of MACEs at 12 months (odds ratio 0.5, P = 0.006). In another randomized study in 67 Chinese patients with non-ST segment-elevation ACS who were randomly assigned to the group of no statin pretreatment or to the rosuvastatin group (20 mg 12 hours before PCI, and a further 20 mg 2 hours before PCI), high loading-dose rosuvastatin therapy before PCI was associated with the reduction of periprocedural myocardial infarction, MACEs, and inflammatory response 70. A very recent randomized, double-blind, placebo-controlled study showed that a single high dose (20 mg) of rosuvastatin prior to PCI reduced postprocedural myocardial injury in Chinese patients with ACS, with a concomitant attenuation of postprocedural increase in hsCRP and interleukin 6 levels,71 suggesting that these beneficial effects of statin pretreatment on clinical outcomes are possibly via inhibition of the periprocedural inflammatory response.…”

Section: Cardiovascular Eventsmentioning

confidence: 99%

Current perspectives on rosuvastatin

Hu¹,

Tomlinson²

2013

IBPC

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Rosuvastatin is one of the most potent statins available for reducing circulating low-density lipoprotein cholesterol (LDL-C) levels, which enables more high-risk patients to achieve their lipid goals. Its favorable balance of effects on atherogenic and protective lipoproteins and its pleiotropic effects, including anti-inflammatory and antioxidant effects and improvement in endothelial dysfunction, are associated with slowing of progression of atherosclerosis within the artery wall and have been translated into clinical benefits for cardiovascular outcomes. This review provides an update on the safety and the efficacy of rosuvastatin in recent large clinical trials. It appears that rosuvastatin has a beneficial effect on the progression of atherosclerosis across the clinical dosage range of 2.5–40 mg. It reduced cardiovascular events in relatively low-risk subjects with elevated high-sensitivity C-reactive protein and normal low-density lipoprotein cholesterol. As with other statins, rosuvastatin did not show overall benefit in terms of survival in patients with heart failure, but certain clinical or biochemical markers reflecting underlying disease characteristics may help to identify subgroups of patients that benefit from statin therapy. In patients with end-stage renal disease undergoing chronic hemodialysis, rosuvastatin had no effect on reducing cardiovascular events. Although there is a slightly increased risk of incident diabetes with this class of agents, the absolute benefits of statin therapy on cardiovascular events overweigh the risk in patients with moderate or high cardiovascular risk or with documented cardiovascular disease. As with other statins, rosuvastatin is an appropriate therapy in addition to antihypertensive treatment to reduce cardiovascular risk in hypertensive patients.

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The effects and mechanisms of high loading dose rosuvastatin therapy before percutaneous coronary intervention in patients with acute coronary syndrome

Cited by 16 publications

References 15 publications

Promoting endothelial recovery and reducing neointimal hyperplasia using sequential-like release of acetylsalicylic acid and paclitaxel-loaded biodegradable stents

Promoting endothelial recovery and reducing neointimal hyperplasia using sequential-like release of acetylsalicylic acid and paclitaxel-loaded biodegradable stents

Intensive versus non-intensive statin pretreatment before percutaneous coronary intervention in Chinese patients: a meta-analysis of randomized controlled trials

Current perspectives on rosuvastatin

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