title: Effect of different loading doses of atorvastatin on percutaneous coronary intervention for acute coronary syndromes.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI)-induced myocardial damage is associated with late cardiovascular events. Treatment with atorvastatin before PCI can reduce myocardial damage during the peri-PCI period.
  
  
  OBJECTIVE
  To compare the safety and myocardial effects of different atorvastatin loading doses and dosing frequency before PCI in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients.
  
  
  METHODS
  Eighty NSTE-ACS patients were randomly divided into four groups (20 patients per group). The control group was given 40 mg atorvastatin each night. The three loading dose groups were treated the same as in the control group, but were given 80 mg atorvastatin 12 h before PCI (lowload group) in combination with 40 mg atorvastatin 2 h to 4 h before PCI (mid-load group) or 60 mg atorvastatin 2 h to 4 h before PCI (high-load group). All patients underwent PCI within 48 h to 72 h of admission, and received 40 mg atorvastatin for at least one month after PCI. Changes in myocardial markers and highly sensitive C-reactive protein were analyzed. Patients were followed up for 30 days to monitor the incidence of major adverse cardiac events (MACE).
  
  
  RESULTS
  No deaths or revascularizations were recorded. The incidences of MACE differed significantly between the four groups (40%, 25%, 10% and 0% for the control, low-load, mid-load and high-load groups, respectively; P<0.05). The incidence of MACE and cardiac troponin I level above the normal range, and post-PCI increases in creatine kinase-MB and highly sensitive C-reactive protein were significantly higher in the control group than in the high-load group (all P<0.007). The post-PCI alanine aminotransferase levels in all four groups were significantly higher than the pre-PCI levels, but were within normal ranges. No myalgia or myasthenia was observed.
  
  
  CONCLUSIONS
  The results of the present study show that short-term atorvastatin loading before PCI was well tolerated and had beneficial myocardial effects in patients with NSTE-ACS.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Yujiao
authors.initials: Y
authors.lastname: Sun
authors.forename: Guoxian
authors.initials: G
authors.lastname: Qi
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.forename: Haishan
authors.initials: H
authors.lastname: Zhang
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Pang
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhao
authors.forename: Zixin
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000188:drug therapy*; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000494:pharmacology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011300:Preoperative Care; D011758:Pyrroles / Q000008:administration & dosage* / Q000494:pharmacology*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D019210:Troponin I; D002097:C-Reactive Protein; D000069059:Atorvastatin; D000410:Alanine Transaminase; D052279:Creatine Kinase, MB Form