Effect of Two-Day Atorvastatin Pretreatment on the Incidence of Periprocedural Myocardial Infarction Following Elective Percutaneous Coronary Intervention: A Single-Center, Prospective, and Randomized Study

Update on the efficacy of statin treatment in acute coronary syndromes

“…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]. However, the small sample size of some randomized trials [34,36,37] and the observational design of other studies [28,30] may impair the statistical power and then their reliability to identify a protective effect over a long-term follow-up, as suggested by Lev and coworkers [33].…”

“…On the other hand, other clinical studies showed controversial results on this role for statins [28,30,34,36,37]. However, the small sample size of some randomized trials [34,36,37] and the observational design of other studies [28,30] may impair the statistical power and then their reliability to identify a protective effect over a long-term follow-up, as suggested by Lev and coworkers [33]. The mechanisms by which statins might prevent PCI-induced adverse CV events are still a matter of debate.…”

“…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.…”

Efficacy of Atorvastatin Reload in Patients on Chronic Statin Therapy Undergoing Percutaneous Coronary Intervention

“…For example, a recent trial evaluated the benefit from 2 days of 80 mg of atorvastatin given to stable, statin-naïve patients prior to PCI, and it did not reveal a statistical benefit in periprocedural MI [4]. This trial was not placebo controlled and it was not blinded.…”

Estudo randomizado da intervenção coronária percutânea após administração da rosuvastatina para prevenção de infarto do miocárdio periprocedimento

“…Embora este procedimento seja seguro e com baixos índices de complicações, a elevação de biomarcadores cardíacos ocorre em 5% a 40% dos pacientes, a depender do biomarcador cardíaco utilizado, das abordagens antitrombóticas, do perfil clínico e angiográfico do paciente [1][2][3][4] . [28][29][30][31][32][33][34][35][36][37][38][39][40] Como ainda não existe estudo sobre a realização da ICP na hora do pico de concentração da estatina, permanecem dúvidas sobre definição de temporalidade adequada para sua administração (de horas até semanas), a dose ideal e o tipo de estatina.…”