Effect of a Single High Loading Dose of Rosuvastatin on Percutaneous Coronary Intervention for Acute Coronary Syndromes

Wang, Zhengzhong; Dai, Hongji; Xing, Mingqing; Yu, Zhuang; Lin, Xun; Wang, Shoudong; Zhang, Junyi; Hou, Fangjie; Ma, Ying; Ren, Yuying; Tan, Kai; Wang, Yanping; Ge, Zhiming

doi:10.1177/1074248412474346

Cited by 30 publications

(42 citation statements)

References 39 publications

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“…In addition, the NAPLES II trial showed that a single loading dose of atorvastatin (80 mg) within 24 h before PCI was effective in improving inhospital CV outcome (OR 0Á56 [CI 95% 0Á35-0Á89]; P = 0Á014), especially the recurrence of AMI (5% vs. 15%; P = 0Á04) in patients undergoing elective coronary angiography for symptomatic coronary artery disease [32]. More recently, several studies and a meta-analysis confirmed these findings, showing the effectiveness of a statin loading dose before PCI to improve short-term CV outcomes (RR 1Á08 [CI 95% 1Á02-1Á14]; P = 0Á01) [38,[40][41][42]. On the other hand, other clinical studies showed controversial results on this role for statins [28,30,34,36,37].…”

Section: Statin-associated Benefits In Patients Admitted For Acs Undesupporting

confidence: 58%

“…However, vascular injury following coronary angioplasty and stent displacement is still frequent and strongly worsen short-and longterm event-free survival [26]. Several studies reported that preoperative administration of statins might reduce the incidence of adverse effects after PCI [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] (Table 3). The Atorvastatin for Reduction of MYocardial Damage During Angioplasty-Acute Coronary Syndromes (ARMYDA-ACS) [29] and Novel Approaches for Preventing or Limiting Events (NAPLES) II trials [32] are the first large clinical trials supporting the use of a loading dose of atorvastatin (80 mg) before coronary PCI, to improve the short-term outcomes.…”

Section: Statin-associated Benefits In Patients Admitted For Acs Undementioning

confidence: 99%

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Update on the efficacy of statin treatment in acute coronary syndromes

Rosa

Carbone

Parodi

et al. 2014

Eur J Clin Investigation

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Background The natural history of atherosclerosis might involve coronary plaque rupture/erosion, thrombus formation and vessel lumen occlusion, clinically recognized as acute coronary syndrome (ACS). International guidelines strongly recommend early statin administration in patients admitted for ACS. In addition to lowering circulating levels of low-density lipoprotein cholesterol (LDL-c), statin treatment was shown to promote plaque stabilization or regression in several ways, including reduction in necrotic lipid core, anti-inflammatory effects and improvement in endothelial function. The aim of this review is to summarize clinical evidence on the role of statins in secondary prevention of ACS.

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Section: Statin-associated Benefits In Patients Admitted For Acs Undesupporting

confidence: 58%

Section: Statin-associated Benefits In Patients Admitted For Acs Undementioning

confidence: 99%

Update on the efficacy of statin treatment in acute coronary syndromes

Rosa

Carbone

Parodi

et al. 2014

Eur J Clin Investigation

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“…Briel et al [16] conducted a meta-analysis including >13,000 patients with acute coronary syndromes demonstrating a significant reduction in the incidence of unstable angina after only 4 months. Other trials have showed that pretreatment with intensive statins before percutaneous coronary intervention in patients with acute coronary syndromes protects the myocardium from periprocedural damage, as defined by the elevation of myocardial necrotic biomarkers, and it reduces the incidence of cardiac events after 30 days [9,17]. Furthermore, it has been demonstrated previously that intensive statin therapy reduces the risk of readmission with heart failure in patients with acute coronary syndromes [18].…”

Section: Discussionmentioning

confidence: 99%

Effects of Intensive Statin Therapy on Left Ventricular Function in Patients with Myocardial Infarction and Abnormal Glucose Tolerance

Auscher

Løgstrup

Møller³

et al. 2017

Cardiology

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Objectives: Abnormal glucose tolerance in patients with acute myocardial infarction (AMI) is associated with greater mortality and adverse cardiovascular effects. As statins possess a range of beneficial pleiotropic effects on the cardiovascular system, we sought to assess the cardioprotective effects of statins on left ventricular function in patients with AMI in relation to glycometabolic state. Methods: In a prospective, randomized trial, 140 patients with AMI were randomized to intensive statin therapy receiving statin loading with 80 mg of rosuvastatin followed by 40 mg daily or standard statin therapy. Patients were assessed with an oral glucose tolerance test and their left ventricular (LV) function was assessed with speckle-tracking echocardiography measuring regional longitudinal systolic strain (RLSS) in the infarct area. Results: Overall RLSS in the infarct area improved by a mean (±SD) of -4.22% (±5.19) in the intensive-care group and -2.48% (±4.01) in the usual-care group after 1 month (p = 0.047). In patients with abnormal glucose tolerance, RLSS improved by -5.01% (±5.28) in the intensive-care group and -2.15% (±4.22) in the usual-care group (p = 0.01). Conclusions: Early high-dose statin treatment improved RLSS in the infarct area in patients with AMI, and a trend of greater improvement was seen in patients with abnormal glucose tolerance.

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“…Clinical trials suggest that pre percutaneous coronary intervention (pre-PCI) administration of atorvastatin might be of substantial benefit [8-15]. Similarly, positive results were reported after pre-treatment with rosuvastatin [8-9,16-18]. If future studies confirm this data, high dose statin pre-treatment before PCI might become standard practice.…”

Section: Introductionmentioning

confidence: 94%

Naproxen and Diclofenac Attenuate Atorvastatin-induced Preconditioning of the Myocardium

Varga

Nemčeková

Čarnická

et al. 2017

Cureus

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Statins reduce infarct size (IS) in ischemia-reperfusion injury of the myocardium. Inhibition of cyclooxygenase-2 (COX-2) attenuates this benefit. We investigated the effect of two widely used non-selective non-steroidal anti-inflammatory drugs (NSAIDs) with different degree of anti-COX-2 activity on atorvastatin-mediated preconditioning. Wistar rats received oral atorvastatin (10 mg∙kg-1∙day-1), naproxen (10 mg∙kg-1∙day-1), diclofenac (8 mg∙kg-1∙day-1), atorvastatin+naproxen, atorvastatin+diclofenac or water for three days. Hearts were then excised and perfused in the Langendorff system. Area at risk (AR) and IS were determined after 30 min of regional ischemia and 120 min of reperfusion. Atorvastatin reduced IS by 51.3% compared with controls (14.7 ± 3.9% vs. 30.2 ± 4.6% of the AR; P < 0.001). Naproxen and diclofenac alone did not alter IS compared to control. Diclofenac completely abrogated atorvastatin-mediated protection of the myocardium. Naproxen significantly attenuated but did not eliminate the IS reducing the effect of atorvastatin when compared with controls (P = 0.038). The difference in IS between the atorvastatin+naproxen group and the atorvastatin+diclofenac group showed a strong trend in reaching statistical significance (P = 0.058), but was not found to be significant. Our results suggest relatively small, but noticeable differences among non-selective NSAIDs in their potential to attenuate statin-mediated preconditioning.

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Effect of a Single High Loading Dose of Rosuvastatin on Percutaneous Coronary Intervention for Acute Coronary Syndromes

Abstract: A single, high dose (20 mg) of rosuvastatin prior to PCI reduces postprocedural myocardial injury in patients with ACS, with a concomitant attenuation of the postprocedural increase in hs-CRP and IL-6 levels.

Cited by 30 publications

References 39 publications

Update on the efficacy of statin treatment in acute coronary syndromes

Update on the efficacy of statin treatment in acute coronary syndromes

Effects of Intensive Statin Therapy on Left Ventricular Function in Patients with Myocardial Infarction and Abnormal Glucose Tolerance

Naproxen and Diclofenac Attenuate Atorvastatin-induced Preconditioning of the Myocardium

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