The Effect Of Atorvastatin Combining With Probucol On Contrast-induced Acute Kidney Injury And Serum Uric Acid

Objective:To observe the effect of different doses of atorvastatin combined with probucol on CIAKI and serum uric acid's level in patients experiencing coronary angiography (CAG) or percutaneous coronary intervention(PCI), especially for the elderly patients or with hypertension, renal insufficiency.Methods:230 cases admitted for coronary angioplasty were randomly divided into three groups: Standard combining treatment group:atorvastatin 20mg qn and probucol 0.25g/tid, no loading dose intake before angioplasty; Intensively combining treatment group: atorvastatin 40mg qn and Probucol 0.25g/tid, with a loading dose of atorvastatin 40mg and probucol 0.5g 2 hours before the angioplasty; Intensive atorvastatin therapy group:atorvastatin 40mg qn, with a loading dose of atorvastatin 40mg 2 hours before the angioplasty. All patients were then evaluated 24 hours before and after the angioplasty procedure, and their blood urea nitrogen (BUN), serum creatinine (Scr), serum uric acid(SUA), all items of renin, estimated glomerular filtration rate (eGFR) by MDRD method were tested. The serum and urine of 24 hours before and after operation were collected. Cystatin C (CysC) and Neutrophil Gelatinase Associated Lipocalin(NGAL) were determinated by ELISA kit.Patients were followed up for 90 days and clinical terminal events were recorded.Results:①After operation, the BUN of all groups decreased; Scr and uNGAL in Standard combining treatment group and Intensive atorvastatin therapy group increased;while eGFR of the two groups decreased(p<0.05); there were no difference in Scr, eGFR and uNGAL of Intensively combining treatment group (p> 0.05);②SUA in Standard combining treatment group and Intensively combining treatment group decreased (p<0.05);there was no difference in Intensive atorvastatin therapy group (p>0.05).③here were no difference in no-mace-survival for 90 days among three groups (Log-Rank, p>0.05).④For hypertensive patients, Scr in Standard combining treatment group and Intensive atorvastatin therapy group increased;while eGFR of the two groups decreased (p<0.05); CysC in Intensive atorvastatin therapy group increased and in Intensively combining treatment group decreased, there were no difference in Scr and eGFR of Intensively combining treatment group (p> 0.05); SUA in Intensively combining treatment group decreased (p＜0.05).AngⅡin Standard combining treatment group increased (p<0.05)⑤For renal insufficiency patients, Scr and uNGAL in Standard combining treatment group increased;while eGFR decreased (p<0.05); Scr and eGFR showed no changes of Intensively combining treatment group and Intensive atorvastatin therapy group (p>0.05); CysC in Intensively combining treatment group decreased. SUA in Standard combining treatment group and Intensively combining treatment group decreased (p<0.05)⑥For elderly patients, eGFR in Standard combining treatment group decreased, while uNGAL increased (p<0.05).Scr,eGFR and uNGAL showed no changes of Intensively combining treatment group and Intensive atorvastatin therapy group (p>0.05); while BUN of the two groups decreased (p<0.05);SUA in Intensively combining treatment group decreased (p<0.05)Conclusions:Combination treatment of atorvastatin and probucol before operation could reduce perioperative serum uric acid's level;while only intensively combining treatment could effective improve CIAKI. Of course,it was safety to take medicine for shot-time.For hypertensive patients, combinatin and intensive treatment could improve the CIAKI,also decrease uric acid's level. For renal insufficiency patients, intensive atorvastatin therapy or combinatin and intensive treatment both could improve CIAKI, combination treatment of atorvastatin and probucol could reduce serum uric acid's level. For elderly patients, intensive atorvastatin therapy and combining intensive treatment both could improve CIAKI,only combinatin and intensive treatment benefit for uric acid.