title: Randomized trial of statin administration for myocardial injury: is intensive lipid-lowering more beneficial than moderate lipid-lowering before percutaneous coronary intervention?
abstract: BACKGROUND
  Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy.
  
  
  RESULTS
  Subjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C)<70 mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C<100 mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial damage was 14.2% in Group A and 47.6% in Group B (p=0.043). CK-MB was above the upper limit of normal (ULN) in 19% of Group A and 33.3% of Group B (p=0.44), and CK-MB was >3x ULN in 9.5% of Group A and 19% of Group B (p=0.66).
  
  
  CONCLUSIONS
  Intensive lipid-lowering therapy before PCI reduces minor myocardial damage during PCI with stenting compared with moderate lipid-lowering therapy.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, and Division of Cardiology, The Shizuoka Municipal Shimizu Hospital, Japan. kinohisa@dance.ocn.ne.jp
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Shin-ichirou
authors.initials: S
authors.lastname: Matsumura
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Sueyoshi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015607:Stents; D020107:Troponin T / Q000097:blood
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D020107:Troponin T