Effect of statin therapy prior to elective percutaneous coronary intervention on frequency of periprocedural myocardial injury.
This study evaluated whether pretreatment with statins was associated with a decreased incidence of periprocedural myocardial injury. Periprocedural myocardial injury occurs after percutaneous coronary intervention (PCI) and is associated with adverse outcomes. The pleiotropic properties of statins stabilize plaque and decrease the inflammatory milieu of atherosclerotic lesions. Accordingly, we hypothesized that preprocedural statin therapy would decrease periprocedural myocardial injury. We enrolled 425 patients who underwent successful PCI. The control arm (n = 150) included patients not on statin therapy at the time of PCI, and the statin arm (n = 275) included patients who were taking statin medication before PCI. All patients had serial enzymes measured, including creatine kinase (CK), CK-MB, and troponin I. The incidence of increased levels of CK and CK-MB >3 times normal and the absolute increase in CK and troponin I were compared between groups. The control arm had significantly higher periprocedural levels of CK. In the control group, 6% of patients had CK increases >3 times the upper limit of normal compared with 1.8% in the statin group (p = 0.02). The control arm had a higher frequency of CK-MB increases >3 times the upper limit of normal (7.3% vs 2.2%, p = 0.01). There was a trend toward higher levels of troponin I in the control group (3.21 vs 1.85 ng/ml, p = 0.06). Thus, statin therapy before elective PCI was associated with lower levels of periprocedural CK.
Mulukutla
Suresh R
SR
Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. mulukatlasr@msx.upmc.edu
Marroquin
Oscar C
OC
Smith
Conrad
C
Varghese
Rekhi
R
Anderson
William D
WD
Lee
Joon S
JS
Cohen
Howard A
HA
Counihan
Peter J
PJ
Lee
Ashley B
AB
Gulati
Vijay
V
McNamara
Dennis
D
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003402:Creatine Kinase / Q000032:analysis; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000517:prevention & control*; D011300:Preoperative Care; D012307:Risk Factors; D019210:Troponin I / Q000032:analysis
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019210:Troponin I; D003402:Creatine Kinase