ROMA II RELOAD: Additional charge of statin (rosuvastatin 40 mg or atorvastatin 80 mg within 24 hours of procedure) in patients on whom elective angioplasty is performed.

ROMA II RELOAD multicenter study (General Hospital Umberto I, University of Rome, Rome, Italy) assessed the impact of an additional charge of statin in patients undergoing elective angioplasty. All patients received a rosuvastatin dose of 40 mg (GR) or atorvastatin 80 mg (GA) within 24 hours of the procedure. The primary endpoint of the study was the CK-MB elevation rate of ≥ 3 above normal values (myonecrosis) at 12 and 24 hours post-procedure. Several studies have shown that the enzyme elevation or myonecrosis after angioplasty occurs in 30% of cases and this elevation is associated with a worse outcome at follow-up. Previously, researchers of this study reported that a 40 mg rosuvastatin dose, periprocedural in patients without prior treatment with statins, reduced myonecrosis occurrence. It should be noted that in this study, ROME II RELOAD, chronic intake of statins before procedure was an inclusion criterion and this was not interrupted by the study. Researchers included in their analysis a third group or control group, consisting of patients on chronic statin angioplasty treatment but who were excluded from randomization. At 12 and 24 hours, myonecrosis occurred in similar frequency in the groups treated with rosuvastatin and atorvastatin. (12 h: 7.1% vs. GR. 6.1% GA, p = NS) (24 h: 8.9% vs. GR. 8.3% GA, p = NS). On the other hand, myonecrosis was more frequent in the control group at 12 hours (25%, p = 0.0001) and 24 h (29.1%, p = 0.0001). Conclusion: Atorvastatin charge using 80 mg or rosuvastatin 40 mg have similar efficacy in reducing myonecrosis.

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Gennaro Sardella