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Use of statins prior to percutaneous coronary intervention reduces myonecrosis and improves clinical outcome
- Source :
- Catheterization and Cardiovascular Interventions. 62:193-197
- Publication Year :
- 2004
- Publisher :
- Wiley, 2004.
-
Abstract
- Primary and secondary prevention with statins reduce major cardiac events in patients with coronary artery disease. The impact of pretreatment with statins prior to percutaneous coronary intervention (PCI) is not well established. The objective of this study was to determine if pretreatment with statins prior to PCI reduce myonecrosis and improve clinical outcome. One hundred nineteen consecutive patients with acute coronary syndrome who underwent PCI were identified. We compared the incidence of myonecrosis defined as peak elevation of CK-MB or CK three time above upper limit of normal within 24 hr and the 6-month cardiovascular event rate (death, nonfatal myocardial infarction unrelated to PCI, target vessels revascularization, and unstable angina requiring hospitalization) among patients who received statins prior to PCI (n = 63) to those who did not (n = 56). Pretreated patients were more likely to have history of myocardial infarction or revascularization (63% vs. 43%; P = 0.015), hyperlipidemia (80% vs. 48%; P = 0.001), hypertension (83% vs. 49%; P = 0.02), and use of angiotensin-converting enzyme inhibitor (62% vs. 38%; P = 0.008). The rest of baseline characteristics were similar between the two groups, including use of glycoprotein IIb/IIIa inhibitors, number of diseased vessels, and type of lesions. Patients pretreated with statins had a significantly lower incidence of myonecrosis (2% vs. 10%; P = 0.04) at 24 hr and a significantly lower clinical event (CE) rate at 6 months (17% vs. 21%; P = 0.015). Of patients not pretreated with statins, 72% were taking statins at 6 months as compared to 98% of pretreated patients. After adjusting for all baseline characteristics, use of statins prior to PCI was associated with a marked decrease in risk of all CEs (OR = 0.2; CI = 0.06-0.63; P = 0.006). Statin therapy prior to PCI may reduces peri-PCI myonecrosis and late cardiac events. These results need to be confirmed in large prospective randomized trials.
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
Statin
medicine.drug_class
medicine.medical_treatment
Myocardial Infarction
Angiotensin-Converting Enzyme Inhibitors
Coronary Disease
Platelet Glycoprotein GPIIb-IIIa Complex
Revascularization
Coronary artery disease
Necrosis
Predictive Value of Tests
Internal medicine
medicine
Creatine Kinase, MB Form
Humans
Radiology, Nuclear Medicine and imaging
Prospective Studies
cardiovascular diseases
Myocardial infarction
Angioplasty, Balloon, Coronary
Creatine Kinase
Unstable angina
business.industry
Incidence
Myocardium
Percutaneous coronary intervention
Cholesterol, LDL
Syndrome
General Medicine
Middle Aged
medicine.disease
Isoenzymes
Treatment Outcome
Conventional PCI
Cardiology
Drug Therapy, Combination
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
Risk Reduction Behavior
Biomarkers
Follow-Up Studies
Subjects
Details
- ISSN :
- 1522726X and 15221946
- Volume :
- 62
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....162898eb829392e53f0c26479f4ee701