title: Effects of loading dose of atorvastatin before percutaneous coronary intervention on periprocedural myocardial injury.
abstract: OBJECTIVE
  To investigate the effects of loading dose of atorvastatin on periprocedural myocardial injury and inflammatory reaction in patients with non-ST segment elevation (NSTE) acute coronary syndromes (unstable angina or NSTE acute myocardial infarction).
  
  
  METHODS
  A total of 81 patients with NSTE-acute coronary syndromes were randomly divided into the pretreatment with atorvastatin group [80 mg 12 h before percutaneous coronary intervention (PCI), with a further 40 mg preprocedure dose] (n=41) or the placebo group (n=40). The main end point was a 30-day incidence of major adverse cardiac events (cardiac death, nonfatal acute myocardial infarction, or revascularization with either PCI or coronary artery bypass grafting). Creatine kinase-MB, cardiac troponin I, and high-sensitivity C-reactive protein levels were measured at the baseline and at 8 and 24 h after the procedure.
  
  
  RESULTS
  Major adverse cardiac events occurred in 2.4% of patients in the atorvastatin group and 22.5% of those in the placebo group (P=0.0161). This difference was mostly because of reduction in the incidence of myocardial infarction (2.4 vs. 20.0%; P=0.0307). Markers of the two groups were elevated after PCI; however, the higher values of creatine kinase-MB, cardiac troponin I, and high-sensitivity C-reactive protein in the atorvastatin treatment group were significantly lower than those in the placebo group (P<0.01).
  
  
  CONCLUSIONS
  Short-term pretreatment with a high dose of atorvastatin significantly reduces procedural myocardial injury in early PCI.
authors.affiliation: Department of Cardiology, Qilu Hospital, Shandong University, Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Jinan, PR China.
authors.forename: Xing Long
authors.initials: XL
authors.lastname: Yu
authors.forename: Hai Juan
authors.initials: HJ
authors.lastname: Zhang
authors.forename: Shao Da
authors.initials: SD
authors.lastname: Ren
authors.forename: Jing
authors.initials: J
authors.lastname: Geng
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Wu
authors.forename: Wen Qiang
authors.initials: WQ
authors.lastname: Chen
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Ji
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.forename: Zhi Ming
authors.initials: ZM
authors.lastname: Ge
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D002681:China; D052279:Creatine Kinase, MB Form / Q000097:blood; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D013997:Time Factors; 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; D052279:Creatine Kinase, MB Form