Preprocedural statin therapy reduces the risk and extent of cardiac biomarker release following percutaneous coronary intervention

Abstract

This study evaluates the association between statin therapy in patients treated by percutaneous coronary intervention (PCI) for stable angina pectoris and postinterventional myocardial injury with subsequent long-term clinical outcome. Prospectively collected data on 400 consecutive patients with stable angina pectoris or evidence of inducible myocardial ischemia were analyzed. The incidence of myocardial infarction based on postinterventional release of troponin I>1.5 ng/ml was 12% in the statin pretreated patients and 20% in those not pretreated with statin therapy (P=0.04, odds ratio 1.84, 95% confidence interval 1.06-3.21). Of the patients experiencing a post-PCI troponin elevation>1.5 ng/ml, those pretreated with a statin pre-PCI had a lesser troponin elevation compared with those not receiving a statin pre-PCI (median: 2.9 ng/ml [1.9-11.5] vs 5.0 ng/ml [3.1-8.8]; P<0.001). In the multivariate model, preprocedural statin therapy was identified as the only independent negative predictor of procedure-related myocardial necrosis based on postprocedural troponin elevation. In the 21-month follow-up period, statin pretreated patients were observed to have fewer deaths, revascularizations, or myocardial infarction; however, this difference was not statistically significant. These results suggest that pretreatment with statins in patients undergoing PCI for stable angina pectoris reduces the risk and extent of procedure-related myocardial injury measured by troponin release.

The beneficial effect of high loading dose of rosuvastatin before percutaneous coronary intervention in patients with acute coronary syndrome

“…These pleiotropic effects may potentially improve outcome after PCI. Many studies were demonstrated that early statin therapy among PCI patients is associated with significant mortality and morbidity advantages in different patient subsets [1][2][3][4][20][21][22][23][24][25].…”

Changes of C-reactive Protein are Associated With Myocardial Injury After Successful Percutaneous Coronary Intervention

“…[23][24][25] Many studies have demonstrated that early statin therapy among PCI patients is associated with significant advantages for decreased mortality and morbidity in different patient subsets. 10,[26][27][28] Although the mechanism is not entirely clear, the anti-inflammatory effects of statins might contribute to the reduced myocardial injury during PCI. In the present study, prior statin therapy had no significant effect on postprocedural troponin elevation.…”

Reduction of Peri - Procedural Myocardial injury by Loading dose of Atorvastatin during Elective Percutaneous Coronary Intervention

“…Significant benefit of statin pre-therapy on periprocedural elevation of Troponin-Iwas also demonstrated in many studies. [11][12][13][14] In this study incidence of cTn-I rise following PCI was 86% without atorvastatin pretreatment and 10% with atorvastatin pretreatment. So the incidence of myonecrosis is less in atorvastatin pretreated group and the difference was statistically significant.…”