The aim of this study was to determine whether patients without ST-segment elevation acute coronary syndromes who were not taking statins previously, can receive high doses of rosuvastatin before coronary angiography or angioplasty and if this action could exert protection in renal function and reduce the incidence of contrast-induced nephropathy (CIN).
This prospective study randomized 543 patients without ST segment elevation acute coronary syndrome to receive rosuvastatin, (271 patients), or atorvastatin, (272 patients), twenty-four hours before contrast exposure. The primary endpoint was a creatinine increase greater than or equal to 0.5 mg/dl or greater or equal to 25% after seventy-two hours of contrast exposure. The two groups had similar clinical features and proceedings. The incidence of contrast-induced nephropathy (CIN) was 6.7% in the rosuvastatin group versus 15.1% in the control group, (p = 0.001). The benefit is maintained even for different definitions of contrast-induced nephropathy (CIN). The rosuvastatin group also had lower rates of adverse clinical events at thirty days, (persistent renal damage, need for dialysis, myocardial infarction, stroke or death), of 3.6% versus 7.9% (p = 0.036).
Conclusion: Patients’ distress without ST-segment elevation acute coronary syndromes who undergo early invasive strategy will benefit from high doses of rosuvastatin from baseline, exerting additional benefit in the prevention of CIN and with better short-term clinical outcomes.
anna_toso_acc2013
Anna Toso
2013-03-12
Original title: Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome – PRATO ACS Study