Comparison of Usefulness of Simvastatin 20 mg Versus 80 mg in Preventing Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Xinwei, Jia; Fu, Xianghua; Zhang, Jing; Gu, Xing; Li, Xue; Fan, Wei; Hao, Guiyang; Yunfa, Jiang; Wu, Weili; Li, Shi-Qiang

doi:10.1016/j.amjcard.2009.04.014

Cited by 106 publications

(77 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also, all included patients underwent PCI (higher volume of contrast media consumption). Other studies reported the same favorable effect upon using rosuvastatin [29] and simvastatin [30]. On the other hand, some studies negated these merits, reporting no significant decline in incidence of CIN in patients receiving high loading doses of statins before exposure to contrast media [7,8].…”

Section: Comparison With Previous Studiesmentioning

confidence: 85%

Impact of High Loading Dose of Atorvastatin in Diabetic Patients with Renal Dysfunction Undergoing Elective Percutaneous Coronary Intervention: A Randomized Controlled Trial

Shehata

Hamza

2015

Cardiovascular Therapeutics

View full text Add to dashboard Cite

SUMMARYIntroduction: The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results. Aim: This study sought to evaluate the role of atorvastatin in prevention of CIN in diabetic patients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI). Methods: 130 patients with mean glomerular filtration rate of 48.5 AE 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 lmol/L) or >25% of baseline value was considered as CIN. Results: Mean age of the study cohort was 56 AE 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05). Conclusion: Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabetic patients with CKD undergoing PCI.

show abstract

Section: Comparison With Previous Studiesmentioning

confidence: 85%

Impact of High Loading Dose of Atorvastatin in Diabetic Patients with Renal Dysfunction Undergoing Elective Percutaneous Coronary Intervention: A Randomized Controlled Trial

Shehata

Hamza

2015

Cardiovascular Therapeutics

View full text Add to dashboard Cite

show abstract

“…A large number of drugs have been used to protect renal function after PCI, such as aminophylline (Shammas et al 2001;Rohani 2010), theophylline (Wang et al 2001), atrial natriuretic peptide (Chen 2009;Morikawa et al 2009), B-type natriuretic peptide (Zhang et al 2010), mannitol (Kelly et al 2008), prostaglandins (McCullough andTumlin 2009), N-acetylcysteine (Thiele et al 2010), sodium bicarbonate (Masuda 2008) and statins (Xinwei et al 2009); however, few of them (Kowalczyk et al 2007;Zoungas et al 2009) have shown exact protective effects.…”

Section: Discussionmentioning

confidence: 99%

Protective Effects of Anisodamine on Renal Function in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Wang

et al. 2011

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

ST-segment elevation myocardial infarction (STEMI) is the most severe type of heart attack, and primary percutaneous coronary intervention (PCI) is the first line treatment for STEMI. However, these patients are at higher risk of contrast-induced nephropathy (CIN), which increases the length of hospital stay and mortality rate. Anisodamine, an alkaloid extracted from a Chinese herb, has been shown to exert protective effects on the renal function. The aim of this study was to investigate the protective effect of anisodamine on CIN in STEMI patients undergoing primary PCI. A total of 126 consecutive STEMI patients were randomly assigned to receive anisodamine (n = 60) or placebo (control, n = 66) from admission to 24 hours after PCI. The serum creatinine (SCr) concentrations, estimated glomerular filtration rate (eGFR) and incidence of CIN were measured on admission, and 24, 48 and 72 hours after PCI between the two groups. We found that the renal function of all patients after PCI underwent a course from injury to recovery. The incidence of CIN was 5.0%, 8.3%, and 6.7% at 24, 48 and 72 hours, respectively, after primary PCI in anisodamine group, while in control group it was 16.7%, 22.7%, and 19.7%, respectively. The incidence of CIN in anisodamine group was lower than that in control group during 72 hours after PCI (all P < 0.05). In conclusion, intravenous infusion of anisodamine before and after primary PCI may reduce the occurrence of CIN in STEMI patients undergoing primary PCI, without serious side effects.

show abstract

“…flushing, itching, angioedema, hypotension, bronchospasm 27 Determine whether contrast media were administered recently Obtain complete history of recent procedures and diagnostic tests Notify physician if contrast medium was administered within the previous 10 days 30 Avoid administration of contrast media within 3-10 days of procedure 1,18,30 Choose contrast agent Notify appropriate personel (physician, procedure nurses) of patient's risk and need to limit amount of contrast medium to less than 100 mL 11,22,24 Low-osmolarity or iso-osmolar agents are preferred 1,3,15,23,24,30 Obtain medication history Continue current dose of statin 1,32 Give ascorbic acid, 3 g per day before the procedure and 2 g twice daily after the procedure 17,30 Obtain a complete list of medications, including over-the-counter medications Notify physician of nephrotoxic medications Withhold medications as ordered by physician; minimal time to withhold is 48 hours or several days before the procedure 1,9,30 ; preferable time frame is weeks before the procedure, when feasible 20 Maintain optimal fluid balance Continue infusion of isotonic saline (12 hours after procedure) or sodium bicarbonate (6 hours after procedure) 4,5,9,13,15,17,18,30 Monitor for symptoms of fluid overload in patients with left ventricular dysfunction; urine output may be matched with infusion volume 30 Resume administration of diuretics on physician's orders, preferably 24 hours after administration of contrast media 30 Assess serum laboratory values Serum creatinine and electrolyte levels should be monitored daily during the hospital stay 1,17 Reassess glomerular filtration rate ...…”

Section: Rationalementioning

confidence: 99%

Contrast-Induced Nephropathy: Pathophysiology and Preventive Strategies

Jorgensen

2013

Critical Care Nurse

View full text Add to dashboard Cite

Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure, after decreased renal perfusion and nephrotoxic medications. Identification of patients at risk and implementation of preventive strategies can decrease the incidence of this nephropathy. Prevention strategies focus on counteracting vasoconstriction, enhancing blood flow through the nephron, and providing protection against injury by oxygen free radicals. Knowledge of the adverse effects associated with infusion of contrast media, identification of patients at risk for contrast-induced nephropathy, and application of evidence-based prevention strategies allow nurses to assist in the prevention of contrast-induced nephropathy.

show abstract

Comparison of Usefulness of Simvastatin 20 mg Versus 80 mg in Preventing Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Cited by 106 publications

References 27 publications

Impact of High Loading Dose of Atorvastatin in Diabetic Patients with Renal Dysfunction Undergoing Elective Percutaneous Coronary Intervention: A Randomized Controlled Trial

Impact of High Loading Dose of Atorvastatin in Diabetic Patients with Renal Dysfunction Undergoing Elective Percutaneous Coronary Intervention: A Randomized Controlled Trial

Protective Effects of Anisodamine on Renal Function in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Contrast-Induced Nephropathy: Pathophysiology and Preventive Strategies

Contact Info

Product

Resources

About