Prevention Of Contrast Media Induced Acute Renal Function Damage Using Short-term Rosuvastatin

Contrast Induced Nephropathy(CIN) is the third leading cause of hospital-acquired acute renal failure.CIN is defined as in serum creatinine level increases of≥0.5 mg/dl or≥25%, respectively, occurring 48 to 72 hours after contrast exposure.CIN is associated with both shot-and long-term morbidity and motality. So it becomes the hotspot on the prevention of complication.Objective:To study the prevention of Contrast Media Induced Acute Renal Function Damage using short-term rosuvastatin in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention(PCI).Seek the new method to protect renal function, and the sensitive indexes to reflected Contrast Induced Nephropathy.Methods : 125 patients who underwent coronary angiography or percutaneous coronary intervention were divided into receive rosuvastatin (10mg/qn,n=63) or no rosuvastatin (n=62) treatment from 2~3 days before coronary angiography or percutaneous coronary intervention to 3 days after that ,according to the random, double-blind experiment.Urinary NAG,α1-MG,β2-MG,mALB and serum CysC were checked for evidence of tubular or glomerular damage at start(the rosuvastatin group checked before the administration of rosuvastatin),the 1st day and the 2nd day after the administration of a radiocontrast agent. Serum creatinine, Urea were checked at start(the rosuvastatin group checked before the administration of rosuvastatin ),the 2nd day and the 3rd day after the administration of a radiocontrast agent. Observe the adverse clinical event and drug side effects between the two groups.Results :1. Baseline demographics and clinical characteristics were similar between the two groups, with no significant differences observed. 2. There was no significant change in Urea, Scr levels compared to baseline after the administration of a radiocontrast agent in two groups.The incidence of contrast-induced nephropathy, defined as increase of either≥25% or≥0.5 mg/dL in serum creatinine, was 1 in placebo-treated patients and none in rosuvastatin-treated patients , a nonsignificant difference (P >0.05).3. In control group,comparison with the value before the administration of a radiocontrast agent,urinaryα1-MG,serum CysC significantly increased at the 1st day after the administration of a radiocontrast agent(P<0.01). In comparison to the 1st day after the administration of a radiocontrast agent,urinaryα1-MG,serum CysC significantly decreased at the 2nd day after the administration of a radiocontrast agen(tP<0.01), butα1-MG,serum CysC remained at a higher level(P<0.01).In comparison with the value before coronary angiography in atorvastatin-treated group, urinaryα1-MG,serum CysC levels at the 1st day after angiography had no significant change compared to baseline(P>0.05), the same results at the 2nd day too. Compared to the control group, the values of urinaryα1-MG,serum CysC significantly decreased at day and the 2nd day after the administration of a radiocontrast agent in rosuvastatin -treated group(P<0.01).In control group,comparison with the value before the administration of a radiocontrast agent,β2-MG,mALB,NAG do not significantly increased at the 1st day and the 2nd day after the administration of a radiocontrast agent(P<0.01).The same results appearance in atorvastatin-treated group(P<0.01).Butβ2-MG,mALB,NAG intend to increase the 1st day after the administration of a radiocontrast agent between the two groups.In control group and atorvastatin-treated group,comparison with the value before the administration of a radiocontrast agent,hsCRP significantly increased at the 1st day after the administration of a radiocontrast agent(P<0.01).In comparison to the 1st day after the administration of a radiocontrast agent,hsCRP had no significant change at the 2nd day after the administration of a radiocontrast agent(P<0.01).But Compared to the control group, the values of hsCRP significantly decreased at the 1st day and the 2nd day after the administration of a radiocontrast agent in rosuvastatin -treated group(P<0.01).4. There was no difference between rosuvastatin group and placebo group in the inhospital clinical composite outcome and drug side effects. Acute left heart failure,recurrent angina ,deterioration of cardiac function happened between the two groups(p>0.05), the composite outcome of death, myocardial infarction, revascularization, renal failure ,and dialysis after contrast administration was also no difference.Conclusion:1.α1-MG,Cys C are more sensitive than other indexes (NAG,β2-MG,mALB) and traditional indexes (Scr,Urea) to reflect the early changes of renal function.2. Using short-term rosuvastatin decrease the level ofα1-MG,Cys C induced by contrast ,reveal rosuvastatin could protect renal function and prevention of CIN in clinical practice.3. Rosuvastatin improved endothelial function and inflammatory response may be involved in renal protection.