Coronary artery diseaseUsefulness of Statin Pretreatment to Prevent Contrast-Induced Nephropathy and to Improve Long-Term Outcome in Patients Undergoing Percutaneous Coronary Intervention
Section snippets
Methods
Four-hundred eighty consecutive patients undergoing PCI at Campus Bio-Medico University of Rome from June 1, 2000 to June 1, 2001 were evaluated (Figure 1). Patients had signs and/or symptoms of myocardial ischemia and angiographic evidence of significant coronary disease warranting PCI. To minimize the potential role of hemodynamic instability as a cause of postprocedural renal failure, 46 patients with ST-segment elevation acute myocardial infarction <48 hours, cardiogenic shock, or left
Results
In the statin-treated group, 153 patients (59%) were taking atorvastatin, 77 (30%) simvastatin, 19 (7%) rosuvastatin, and 11 (4%) pravastatin; mean duration of statin pretreatment was 10.6 ± 9.1 months. Clinical and procedural characteristics are listed in Table 1, Table 2, respectively. Statin-treated patients were younger and had higher prevalences of hypercholesterolemia, acute coronary syndromes on presentation, previous coronary revascularization, more complex lesions (B2 and C), and more
Discussion
This study indicates that patients receiving statin treatment before PCI have a decreased incidence of postprocedural CIN compared with patients not receiving statins; this benefit is associated with improved long-term clinical outcome, including a significant decrease in cardiac death at 4 years.
Chronic renal failure worsens prognosis in patients with coronary artery disease and in those undergoing coronary angioplasty,12, 13 and development of CIN after PCI correlates with increased risk of
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