ISSN 2996-8215
International Journal of Cardiology | Vol. 6, No. 11, November 2015 | pp. 81–88
DOI: 10.46882/2015/IJC/000080
Original Research Article
Efficacy of High Dose Atorvastatin Reloading Before Complex Percutaneous Coronary Intervention
Yusuf Demir¹, Murat Kaya¹, Ahmet Yilmaz²
¹Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
²Division of Interventional Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
Abstract:
Periprocedural myocardial infarction (pMI) is a common complication during complex percutaneous coronary intervention (PCI). Acute statin reloading limits pMI in statin-naive patients, but its effectiveness during complex interventional procedures in patients already established on chronic maintenance statin treatment requires verification. This prospective, randomized, open-label trial evaluated whether high-dose atorvastatin reloading before complex PCI reduces pMI rates in patients on chronic statin therapy. We enrolled 240 chronic statin users undergoing complex PCI (defined as multi-vessel disease, bifurcation lesions, or chronic total occlusions). Patients were randomized 1:1 to receive either an acute reload of atorvastatin (80 mg given 12 hours and 2 hours pre-PCI, n = 120) or to continue standard maintenance dosing (n = 120). The primary endpoint was the incidence of pMI, defined as an elevation of cardiac troponin I (cTnI) greater than 5 times the upper limit of normal within 24 hours post-procedure. The incidence of pMI was significantly lower in the atorvastatin reloading group than in the control arm (8.3% vs. 16.7%, p = 0.04). Post-procedural mean cTnI values were also significantly reduced with the reload (0.42 ± 0.11 ng/mL vs. 0.88 ± 0.21 ng/mL, p < 0.01). No cases of hepatic dysfunction or rhabdomyolysis occurred. High-dose atorvastatin reloading safely and significantly reduces periprocedural myocardial injury during complex percutaneous coronary intervention in patients on chronic maintenance statin therapy.
Keywords: Percutaneous coronary intervention, Atorvastatin, Statin reloading, Periprocedural myocardial infarction, Complex coronary lesions
Received: August 04, 2015; Revised: September 15, 2015; Accepted: October 10, 2015; Published: November 18, 2015
Citation: International Journal of Cardiology, 2015, Vol. 6, No. 11, pp. 81–88, DOI: 10.46882/2015/IJC/000080