Effect of a single high loading dose of rosuvastatin on percutaneous coronary intervention for acute coronary syndromes.
OBJECTIVE
A high loading dose of atorvastatin has been confirmed to reduce postprocedural events in patients undergoing percutaneous coronary intervention (PCI). In this study, we sought to investigate the protective effects of rosuvastatin in patients with acute coronary syndromes (ACS) undergoing PCI and to determine the effect of rosuvastatin pretreatment on the postprocedural levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and monocyte chemotactic protein 1 (MCP-1).


METHODS
A total of 125 patients with non-ST-segment elevation ACS were randomized to pretreatment with rosuvastatin (20 mg 2-4 hours before PCI [n = 62]) or placebo (n = 63). All the patients received subsequent long-term rosuvastatin treatment (10 mg/d). The main end point of the trial was the 30-day incidence of major adverse cardiac events (death, myocardial infarction, or unplanned revascularization). Plasma levels of hs-CRP, IL-6, and MCP-1 were detected before PCI and 6 hours, 24 hours, and 3 days after PCI.


RESULTS
The primary end point occurred in 8.1% of the patients in the rosuvastatin arm and 22.2% in the placebo arm (P < .01); this difference was entirely attributed to a reduced incidence of myocardial infarction (8.1% vs 22.2%; P < .01). The postprocedural elevation in creatine kinase-MB and troponin I was also significantly lower in the rosuvastatin group at 6 hours, 24 hours, and 3 days. Plasma levels of hs-CRP, IL-6, and MCP-1 increased significantly after PCI in both the rosuvastatin and control groups; however, the postprocedural elevations in hs-CRP and IL-6 levels were significantly lower in the rosuvastatin group than the control group.


CONCLUSIONS
A single, high dose (20 mg) of rosuvastatin prior to PCI reduces postprocedural myocardial injury in patients with ACS, with a concomitant attenuation of the postprocedural increase in hs-CRP and IL-6 levels.
Key Laboratory of Cardiovascular Remodeling and Function, Chinese Ministryof Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan, Shandong, China.
Zhengzhong
Z
Wang
Hongyan
H
Dai
Mingqing
M
Xing
Zhongxiang
Z
Yu
Xianru
X
Lin
Shoudong
S
Wang
Junyi
J
Zhang
Fangjie
F
Hou
Ying
Y
Ma
Yongqiang
Y
Ren
Kai
K
Tan
Yanping
Y
Wang
Zhiming
Z
Ge
D054058:Acute Coronary Syndrome / Q000097:blood / Q000628:therapy*; D000368:Aged; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D018932:Chemokine CCL2 / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015994:Incidence; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*
D018932:Chemokine CCL2; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015850:Interleukin-6; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein
high-sensitivity C-reactive protein; interleukin 6; monocyte chemotactic protein 1; non-ST segment elevation acute coronary syndrome; percutaneous coronary intervention; rosuvastatin