title: Preprocedural statin therapy to prevent myocardial damage in percutaneous coronary intervention: a review of randomized trials.
abstract: Multiple landmark clinical trials have demonstrated the beneficial effects of statin therapy for primary and secondary prevention of cardiovascular disease, but the exact timing of how early to treat relative to acute presentation has been less clear. The benefits of statin in cardiovascular disease can be explained not only by their lipid-lowering potential but also by non-lipid-related mechanisms, called pleiotropic effects. Percutaneous coronary intervention (PCI) can result in myocardial injury that is reflected by an increase in creatine kinase-MB and troponin I isoenzymes with worsened long-term prognosis following PCI. Observational studies suggested that pretreatment with statins might reduce the incidence of myocardial infarction after coronary intervention and prevent myocardial injury. Thus, several randomized controlled trials were conducted. They showed that pretreatment with statin before elective PCI reduces periprocedural myocardial injury in patients with stable angina. Moreover, short-term high-dose statin administration before coronary procedures also improves clinical outcome in patients with acute coronary syndromes and/or high preprocedural C-reactive protein levels. Thus, this evidence strongly supports routine utilization of high-dose statins as adjuvant pharmacological therapy before percutaneous coronary revascularization.
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Via Alvaro del Potillo 200, Rome, Italy. s.mega@unicampus.it
authors.forename: Simona
authors.initials: S
authors.lastname: Mega
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
mesh_terms: D000787:Angina Pectoris / Q000150:complications / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000378:metabolism; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form