Effects Of Loading Dose Of Atorvastatin Before Percutaneous Coronary Intervention On Periprocedural Myocardial Injury

ObjectivesTo investigate the effects of loading dose atorvastatin on periprocedural myocardial injury and inflammatory reaction in patients with non-ST segment elevation acute coronary syndromes (ACS)(unstable angina or non-ST segment elevation acute myocardial infarction) undergoing early percutaneous coronary intervention.The markers of myocardial injury are CK—MB and cardiac troponin (cTnI). The marker of inflammatory reaction is high-sensitivity C—reactive protein(hs—CRP).The main end point of the trial was a 30-day incidence of major adverse cardiac events(cardiac death, nonfatal acute myocardial infarction,or revascularization with either percutaneous coronary intervention or coronary artery bypass grafting.).MethodsA total of 81 patients with non-ST segment elevation ACS were randomized to pretreatment with atorvastatin (80 mg 12 h before PCI,with a further 40 mg preprocedure dose [n=41] or control group[n=40], CK—MB, cTnI, hs—CRP,CK and ALT/AST of the blood from elbow vein were monitored before and 8 and 24 hours after the procedure of PCI.RESULTSThe markers of two groups were elevated after PCI,however,the ascended values of CK—MB, cTnl, hs—CRP in the atorvastatin treatment group were significantly lower than those of the control group(P<0.01). the major adverse cardiac events occurred in 2.4% of patients in the atorvastatin group and 22.5% of those in the control group (P=0.0161).this difference was mostly driven by reduction of myocardial infarction incidence (2.4% vs.20.0%)(P=0.0307).Conclusionseven short-term pretreatment with high dose atorvastatin may improve outcomes in patients with non-ST segment ACS undergoing early invasive strategy.