The Effect Of Loading-dose Atorvastatin On Rental Function In Percutaneous Coronary Intervention Perioperative Period

OBJECTIVE:To study the effect of loading-dose atorvastatin on preventing renal function in percutaneous coronary intervention (PCI) perioperative period and compare the effect of different doses of atorvastatin on preventing contrast-induced nephropathy(CIN).METHODS:1.127 patients, who received coronary interventional diagnosis and treatment from June 2010 to December 2010 in Second Affiliated Hospital of Nanchang University, were divided into three groups.20mg group(48 cases),40mg group(48 cases) and 80mg group(31 cases) were given atorvastatin calcium tablets 20mg/day, 40mg/day,80mg/day before PCI and 20mg/day,40mg/day,40mg/day after PCI respectively.2. Iopromide was used and recorded the amount.3.Fasting serum creatinine (Scr), blood urea nitrogen (BUN) and urineβ2-microglobulin (β2-MG), urine N-acetyl-β-D-glucuronidase (NAG) are monitored in the 1,3,5 day before and after PCI. Glomerular filtration rate (GFR) was estimated. Then data of each group were analyzed and compared.The incidence of CIN was compared among any group.RESULTS1.Among the 127 patients, CIN occurred to 5 patients (3.94%).20mg group, 40mg group and 80mg group were 3 cases (6.25%),1 case(2.08%) and 1 case(3.23%) respectively.2.The result showed that Scr, urineβ2-MG and urine NAG were higher after PCI in all groups while the eGFR was lower. Compared the data of Preoperation and postoperation, the Scr, urine (32-MG and urine NAG in the 20mg group,40mg group and 80mg group were all significantly different (P<0.001) in the 3 day. The eGFR in the 20mg group and the 40mg group was significantly different (P<0.001). And the urine NAG in the 80mg group was significantly different (P<0.001) in the 5 day.3.Compared the 3 groups, the urineβ2-MG and urine NAG were significantly different (P<0.05) in each two groups. The urineβ2-MG and urine NAG in the 20mg group and 80mg group were significantly different (P<0.05).4.The data of the renal function in 20mg group,40mg group and 80mg group have a trend of improvement as the dose of atorvastatin increased.CONCLUSION:1.Using atorvastatin in PCI perioperative period can prevent renal function.2.The loading dose of atorvastatin might further reduce the incident of CIN.3.Atorvastatin is dose-depended in the protection of renal function after PCI.