title: Anti-oxidative stress effect of loading-dose rosuvastatin prior to percutaneous coronary intervention in patients with acute coronary syndrome: a prospective randomized controlled clinical trial.
abstract: OBJECTIVE
  Administration of a loading dose of a statin (HMG-CoA reductase inhibitor) prior to percutaneous coronary intervention (PCI) contributes to protection from myocardial ischemic-reperfusion injury. This trial was designed to investigate the effect and mechanism of loading-dose rosuvastatin therapy before PCI in patients with acute coronary syndrome.
  
  
  METHODS
  One hundred and forty-three patients with acute coronary syndrome were randomized to either the loading-dose (rosuvastatin 40 mg given 4 h before PCI) or conventional-dose (rosuvastatin 10 mg given 4 h before PCI) group. Blood samples were collected before and 0, 24, and 72 h post-PCI for measurement of serum cardiac troponin-I (cTn I), creatine kinase-MB (CK-MB), superoxide dismutase (SOD), reactive oxygen species (ROS), and malondialdehyde (MDA). Echocardiography and the major adverse cardiac/cerebrovascular events (MACCE) rate were followed up for 6 months post-PCI.
  
  
  RESULTS
  Blood serum CK-MB and cTn I were significantly lower in the loading-dose group than in the conventional-dose group at 24 and 72 h post-PCI [CK-MB: 26.90 ± 3.22 vs. 32.96 ± 2.65 IU/L, P = 0.024; 10.79 ± 4.65 vs. 15.18 ± 5.39 IU/L, P = 0.021. cTn I: 0.046 ± 0.007 vs. 0.055 ± 0.002 ng/mL, P = 0.015; 0.027 ± 0.006 vs. 0.041 ± 0.006 ng/mL, P = 0.026]. Echocardiography at 6 months after PCI revealed significant improvement in cardiac function in the loading-dose group compared with the conventional-dose group (P < 0.05). The MACCE rate at 6 months after PCI in the loading-dose group was lower than in the conventional-dose group (P = 0.0428). The levels of MDA and ROS were decreased and the SOD level was significantly higher in the loading-dose group than in the conventional-dose group at 0, 24, and 72 h post-PCI (P < 0.05).
  
  
  CONCLUSIONS
  Administration of loading-dose rosuvastatin in patients with acute coronary syndrome prior to PCI exerts myocardial protection by inhibition of oxidative stress.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28# Fuxing Street, Beijing, 100853, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Liang
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.forename: Hexu
authors.initials: H
authors.lastname: Yang
authors.forename: Ran
authors.initials: R
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Yan
authors.forename: Haokao
authors.initials: H
authors.lastname: Gao
authors.forename: Jinda
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Zhang
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.forename: Feng
authors.initials: F
authors.lastname: Cao
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000601:surgery*; D000284:Administration, Oral; D052279:Creatine Kinase, MB Form / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D019210:Troponin I / Q000097:blood
chemical_list: D005464:Fluorobenzenes; D011743:Pyrimidines; D013449:Sulfonamides; D019210:Troponin I; D000068718:Rosuvastatin Calcium; D052279:Creatine Kinase, MB Form