title: Impact of high loading dose of atorvastatin in diabetic patients with renal dysfunction undergoing elective percutaneous coronary intervention: a randomized controlled trial.
abstract: BACKGROUND
  The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results.
  
  
  OBJECTIVE
  This study sought to evaluate the role of atorvastatin in prevention of CIN in diabetic patients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI).
  
  
  METHODS
  130 patients with mean glomerular filtration rate of 48.5 ± 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 μmol/L) or >25% of baseline value was considered as CIN.
  
  
  RESULTS
  Mean age of the study cohort was 56 ± 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05).
  
  
  CONCLUSIONS
  Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabetic patients with CKD undergoing PCI.
authors: Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: Mohamed
authors: M
authors: Shehata
authors: Mohamed
authors: M
authors: Hamza
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D000069059:Atorvastatin / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D004311:Double-Blind Method; D004534:Egypt; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011446:Prospective Studies; D065840:Protective Factors; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin; D003404:Creatinine
keywords: Contrast-induced nephropathy; Coronary intervention; Diabetes mellitus; Statins