Impacto na função renal de uma dose de reforço de rosuvastatina prévia a intervenção coronária percutânea eletiva nos pacientes em uso crônico de estatina

Abstract

AbStRACtbackground: Contrast-induced nephropathy (CIN) is a potential complication after percutaneous coronary intervention (PCI). The pathogenesis of this complication has been linked to inflammation, endothelial dysfunction and oxidative stress. In this study, statins were investigated as a treatment for CIN because of the pleiotropic effects of these drugs, assessing whether a preload dose of rosuvastatin prior to elective PCI in patients receiving chronic statin treatment reduced the incidence of CIN. Methods: This study was designed as a prospective, randomised, open label, single -centre study. The patients were grouped based on the inclusion (group 1) or exclusion (group 2) of 40 mg rosuvastatin treatment two to six hours prior to PCI. The frequency of CIN in these two groups, as well as the diabetic and renal dysfunction subgroups, was compared. Results: The study comprised 135 patients aged 60.7 ± 9.3 years who were randomised to group 1 (n = 67) or group 2 (n = 68). The overall prevalence of diabetes was 31.1%, and the overall prevalence of a creatinine clearance rate < 60 mL/min was 13.3%. The overall incidence of CIN was 8.1%, with no difference between groups (9% vs. 7.4%; P = 0.89). The incidence of CIN was 15% vs. 13.6% in the diabetic patients (P = 0.75), and 12.5% vs. 0% in those