title: Beneficial effects of high-dose atorvastatin pretreatment on renal function in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate whether preprocedural high-dose atorvastatin decreases the incidence of contrast-induced nephropathy (CIN) and protects the renal function after emergency percutaneous coronary intervention (PCI).
  
  
  METHODS
  Statin-naive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI (n = 161) randomly received atorvastatin (80 mg, n = 78, ATOR group) or placebo [n = 83, control (CON) group] followed by long-term atorvastatin (40 mg/day). The primary end point was incidence of CIN.
  
  
  RESULTS
  In the ATOR group, 2.6% of the patients developed CIN versus 15.7% in the CON group (p = 0.01). In the ATOR group, postprocedural serum creatinine was significantly lower (93.4 ± 17.1 vs. 112.6 ± 23.3 µmol/l at 48 h and 84.2 ± 14.2 vs. 95.3 ± 17.7 µmol/l at 72 h, both p < 0.0001) and in the CON group, peak serum cystatin C was lower (0.51 ± 0.14 vs. 0.61 ± 0.13 mg/l, p < 0.0001). Atorvastatin pretreatment was independently associated with a decreased risk of CIN (OR 0.084, 95% CI 0.015-0.462, p = 0.004). The proportion of alanine aminotransferase > 3 × upper limit of the normal value within 1 month was 3.85 versus 1.20% (ATOR vs. CON group, p = 0.57).
  
  
  CONCLUSIONS
  Preprocedural high-dose atorvastatin prevents CIN and protects the renal function in patients with acute STEMI undergoing emergency PCI.
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xianghua
authors.initials: X
authors.lastname: Fu
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiangnan
authors.initials: X
authors.lastname: Li
authors.forename: Zengxin
authors.initials: Z
authors.lastname: Yang
authors.forename: Xuechao
authors.initials: X
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Geng
authors.forename: Xinshun
authors.initials: X
authors.lastname: Gu
authors.forename: Guozhen
authors.initials: G
authors.lastname: Hao
authors.forename: Yunfa
authors.initials: Y
authors.lastname: Jiang
authors.forename: Weize
authors.initials: W
authors.lastname: Fan
authors.forename: Weili
authors.initials: W
authors.lastname: Wu
authors.forename: Shiqiang
authors.initials: S
authors.lastname: Li
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000069059:Atorvastatin; D003287:Contrast Media / Q000009:adverse effects; D003404:Creatinine / Q000378:metabolism; D055316:Cystatin C / Q000378:metabolism; D004638:Emergency Treatment; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D011758:Pyrroles / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D055316:Cystatin C; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D003404:Creatinine