Early high-dose rosuvastatin and cardioprotection in the Protective effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome (PRATO-ACS) study

Leoncini, Mario; Toso, Anna; Maioli, Mauro; Tropeano, Francesco; Badía, Toni; Villani, Simona; Bellandi, Francesco

doi:10.1016/j.ahj.2014.08.005

Cited by 108 publications

(150 citation statements)

References 24 publications

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“…Although it remains uncertain whether statins lower the risk of contrast-induced AKI or are associated with AKI when used in high doses, they have been consistently shown to lower major adverse cardiovascular events in most populations (37)(38)(39)(40)(41)(42)(43)(44)(45). To our knowledge, there are no published reports of AKI associated with b-blocker use.…”

Section: Discussionmentioning

confidence: 66%

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Leung¹,

Pannu

Tan

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives AKI after coronary angiography is associated with poor long-term outcomes. The relationship between contrast-associated AKI and subsequent use of prognosis-modifying cardiovascular medications is unknown.Design, setting, participants, & measurements A cohort study of 5911 participants 66 years of age or older with acute coronary syndrome who received a coronary angiogram in Alberta, Canada was performed between November 1, 2002, and November 30, 2008. AKI was identified according to Kidney Disease Improving Global Outcomes AKI criteria.Results In multivariable logistic regression models, compared with participants without AKI, those with stages 1 and 2-3 AKI had lower odds of subsequent use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker within 120 days of hospital discharge (adjusted odds ratio, 0.65; 95% confidence interval, 0.53 to 0.80 and odds ratio, 0.34; 95% confidence interval, 0.23 to 0.48, respectively). Subsequent statin and b-blockers use within 120 days of hospital discharge was significantly lower among those with stages 2-3 AKI (adjusted odds ratio, 0.44; 95% confidence interval, 0.31 to 0.64 and odds ratio, 0.46; 95% confidence interval, 0.31 to 0.66, respectively). These associations were consistently seen in patients with diabetes mellitus, heart failure, low baseline eGFR, and albuminuria; 952 participants died during subsequent follow-up after hospital discharge (mean=3.1 years). The use of each class of cardiovascular medication was associated with lower mortality, including among those who had experienced AKI.Conclusions Strategies to optimize the use of cardiac medications in people with AKI after coronary angiography might improve care.

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Section: Discussionmentioning

confidence: 66%

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Leung¹,

Pannu

Tan

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…В проспективное ран-домизированное одноцентровое открытое исследование PRATO-ACS были включены 504 больных при раннем инвазивном лечении ОКС без подъёмов сегмента ST, не получавшие ранее статины [11].…”

Section: High Doses Of Statins Before Pci высокие дозы статинов передunclassified

High Doses of Statins Before Percutaneous Coronary Intervention: Whether There Are Reasons to Use?

Yavelov

Zhatkina

Drapkina

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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1 Национальный медицинский исследовательский центр профилактической медицины Россия, 101990, Москва, Петроверигский пер., 10, стр. 3 2 Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Россия, 117997, Москва, ул. Островитянова, 1В обзоре представлены результаты проспективных рандомизированных клинических исследований, спланированных для оценки эффективности применения высоких доз статинов перед чрескожными коронарными вмешательствами (ЧКВ). Отмечено влияние данного подхода на вы-раженность повреждения миокарда и клинические исходы при плановых ЧКВ у больных со стабильной ишемической болезнью сердца (ИБС) и ЧКВ в ранние сроки острого коронарного синдрома (ОКС) без стойкого подъема сегмента ST на ЭКГ. Продемонстрированы результаты ис-следований, спланированных для изучения частоты возникновения контраст-индуцированной нефропатии, а также данные мета-анализов проведенных клинических испытаний. Согласно накопленным фактам, прием высоких доз статинов до ЧКВ может способствовать уменьшению повреждения миокарда со сниже-нием риска перипроцедурного инфаркта миокарда. Этот эффект продемонстрирован при плановом коронарном стентировании у больных со стабильной ИБС и при ЧКВ в первые дни лечения ОКС без стойкого подъема сегмента ST на ЭКГ. Он отмечался как у больных, ранее не при-нимавших статины, так и у находящихся на постоянном лечении статинами. Дополнительная ожидаемая польза применения высокой дозы статинов до ЧКВ -профилактика контраст-индуцированной нефропатии. Однако из-за ограниченности доказательной базы единого мне-ния о целесообразности подобного подхода в современных клинических рекомендациях нет.Ключевые слова: чрескожное коронарное вмешательство, коронарное стентирование, статины, инфаркт миокарда, острый коронарный син-дром, контраст-индуцированная нефропатия. The results of prospective randomized clinical trials planned to assess the efficacy of using statins in high doses before percutaneous coronary interventions (PCI) are presented in the review. The effect of this approach on the severity of myocardial damage and clinical outcomes in planned PCI in patients with stable ischemic heart disease (IHD) and early PCI in acute coronary syndrome (ACS) without stable ST-segment elevation was found. The results of the trials planned to study the incidence of contrast-induced nephropathy as well as data from meta-analyzes of conducted clinical trials are demonstrated. According to the accumulated facts, taking high doses of statins before PCI can contribute to reduce myocardial damage with a decrease in the risk of periprocedural myocardial infarction. This effect was demonstrated in the planned coronary stenting in patients with stable IHD and in PCI in the first days of treatment of ACS without the stable ST-segment elevation. It was found both in patients who had not previously taken statins and in patients permanently treated with statins. The additional expected benefit of using a high dose of statins prior to PCI is the prevention of contrast-induced nephropathy. However, d...

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“…A number of small studies undertaking alkalinization of urine using a range of agents (bicarbonate, sodium/potassium citrate, acetazolamide) have shown a reduction in the incidence of contrast-induced nephropathy; recent information suggesting the use of high-dose statins in preventing CI-AKI is promising. 203 Although there are theoretical benefits from the use of loop diuretics in early or established AKI, these have not been supported by data in studies, and diuretics are therefore not recommended for the prevention or treatment of AKI. 198 …”

Section: B 201mentioning

confidence: 99%

2014 ESC/ESA Guidelines on Non-cardiac Surgery: Cardiovascular Assessment and Management

Kristensen¹,

Knuuti²,

Saraste³

et al. 2014

Revista Española de Cardiología (English Edition)

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Early high-dose rosuvastatin and cardioprotection in the Protective effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome (PRATO-ACS) study

Cited by 108 publications

References 24 publications

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

High Doses of Statins Before Percutaneous Coronary Intervention: Whether There Are Reasons to Use?

2014 ESC/ESA Guidelines on Non-cardiac Surgery: Cardiovascular Assessment and Management

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