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  • Title: Impact of high loading dose of atorvastatin in diabetic patients with renal dysfunction undergoing elective percutaneous coronary intervention: a randomized controlled trial.
    Author: Shehata M, Hamza M.
    Journal: Cardiovasc Ther; 2015 Apr; 33(2):35-41. PubMed ID: 25677920.
    Abstract:
    INTRODUCTION: The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results. AIM: This study sought to evaluate the role of atorvastatin in prevention of CIN in diabetic patients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI). METHODS: 130 patients with mean glomerular filtration rate of 48.5 ± 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 μmol/L) or >25% of baseline value was considered as CIN. RESULTS: Mean age of the study cohort was 56 ± 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05). CONCLUSION: Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabetic patients with CKD undergoing PCI.
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