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Novel Approaches for Preventing or Limiting Events (Naples) II Trial: Impact of a Single High Loading Dose of Atorvastatin on Periprocedural
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| 18.08.2009, 22:56 |
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Objectives Atorvastatin administered at least 7 days before the percutaneous coronary intervention (PCI) reduces the rate
of periprocedural myocardial infarction (MI). It is unknown whether a single, high (80 mg) loading dose of atorvastatin
may reduce the rate of periprocedural MI.
Background Periprocedural MI is a prognostically important complication of PCI.
Methods Six hundred and sixty-eight statin-naive patients the day before the elective PCI were randomly assigned to atorvastatin
80 mg (atorvastatin group; n 338) or no statin treatment (control group; n 330). Creatine kinase
myocardial isoenzyme (CK-MB) (upper limit of normal [ULN] 3.5 ng/ml) and cardiac troponin I (ULN 0.10 ng/ml)
were assessed before and 6 and 12 h after the intervention. Periprocedural MI was defined as a CK-MB elevation
3 ULN alone or associated with chest pain or ST-segment or T-wave abnormalities.
Results The incidence of a periprocedural MI was 9.5% in the atorvastatin group and 15.8% in the control group (odds
ratio: 0.56; 95% confidence interval: 0.35 to 0.89; p 0.014). Median CK-MB peak after PCI was 2.10 ng/ml
(interquartile range 1.00 to 12.50 ng/ml) in the atorvastatin group and 3.20 ng/ml (interquartile range 1.37 to
16.07 ng/ml) in the control group (p 0.014). The incidence of cardiac troponin I elevation 3 ULN was
26.6% in the atorvastatin group and 39.1% in the control group (odds ratio: 0.56; 95% confidence interval:
0.40 to 0.78; p 0.001).
Conclusions A single, high (80 mg) loading (within 24 h) dose of atorvastatin reduces the incidence of periprocedural MI in
elective PCI. (J Am Coll Cardiol 2009;54:00–00) © 2009 by the American College of Cardiology Foundation
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| Категория: Статьи | Добавил: nbylova
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