The renoprotective effects of simvastatin and atorvastatin in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Abstract

Some statins, such as atorvastatin, have proven renoprotective effects. The comparative renoprotective potential of simvastatin is less clear. This study aimed to compare the renoprotective effects of simvastatin with atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This observational study examined the medical records of 271 patients who were treated at the Guangdong Cardiovascular Institute from April 2004 to February 2008. Patients had received either 40 mg simvastatin (n = 128) or 20 mg atorvastatin (n = 143), daily, for a period of at least 6 months following PCI. Declined renal function (DRF) was defined at the occurrence of chronic kidney disease (CKD) or elevated CKD stages at 6-months post-PCI. Results showed that the incidence of DRF was similar among patients taking simvastatin or atorvastatin (25.00% vs 26.57%, respectively). Kaplan–Meier survival analysis showed that patients who developed DRF had a higher incidence of mortality and major adverse cardiovascular events (MACEs) than those without DRF (17.41% vs 28.57%, P = .0308). Multivariate logistic regression analysis identified diabetes and baseline estimated glomerular filtration rate as independent risk factors for DRF. Collectively, our results indicate that simvastatin has comparable renoprotective effects to atorvastatin in ACS patients undergoing PCI. Further studies are warranted to confirm the comparative renoprotective effects of statins.

MIF mRNA Expression and Soluble Levels in Acute Coronary Syndrome

“…Moreover, cardiovascular biomarkers are useful for the diagnosis and management of the patients; we found in ACS patients that CK and troponine I values were over the reference value, and it is already known that their elevated levels are associated with cardiac injury and myonecrosis [ 28 ]. Regarding biochemical parameters like glucose, cholesterol, triglycerides, HDLc, and LDLc, all levels were under the reference value except glucose; it is important to highlight that ACS patients were recruited after the acute event and that they are under pharmacological treatment, specifically statins, and it is already known that the statins are a family of cholesterol-lowering drugs [ 26 ]. On the other hand, MIF is a multifunctional cytokine that acts as a major regulator of inflammation and a central upstream mediator of innate immune response [ 16 ].…”

Effects of atorvastatin on p38 phosphorylation and cardiac remodeling after myocardial infarction in rats

“…Some scholars believe that atorvastatin can resist inflammation, oxidation and arrhythmia, and improve cardiac remodeling. The long-term administration of atorvastatin can improve patient prognosis and reduce the incidence of adverse events ( 7 , 16 ). However, the exact mechanism is unknown.…”

The Effect of Total Cholesterol Variability on Clinical Outcomes After Percutaneous Coronary Intervention

“…PCI was performed by experienced interventional cardiologists according to standard national practice as described in previous researches ( 14 ). The use of statins, antiplatelet agents (aspirin/clopidogrel), β-adrenergic blocking agents, angiotensin-converting enzyme inhibitors, diuretics, or inotropic drugs was based on the discretion of the attending cardiologist according to clinical protocol derived from national interventional guidelines.…”