Effect Of Different Dose Of Atorvastatin On Short Term Renal Function And Myocardial Protection After Percutaneous Coronary Intervention On Patients With Acute Coronary Syndrome

Objective to study the protective effect and mechanism of different doses of atorvastatin on renal function caused by contrast agent and on myocardial in patients implanting stent with ACS.Methods a total of 80 patients with ACS undergoing PCI were randomly received atorvastatin 20mg (A20,n=40) and atorvastatin 40mg (A40,n=40) treatment for 2 to 3 days before PCI. Urinaryα1-MG, TRF and mALB were measured at admission ,the day of PCI and 24 and 48 hours after PCI.Serum creatinine,BUN ,cystain C and hsCRP levels were also measured before and after the procedure.Ccr and GFR were calculated according to Cockcroft-Gault and GFR(ml/min)=74.835/CysC1.333 formulas basing on serum creatinine or cystatin C concentration.And the incidence of contrast-induced nephropathy was calculated according to the clinic data.The primary end point was development of CIN, whichwas defined as a postprocedure increase in serum creatinine of≥44.2 mol/L (0.5 mg/dl) or >25% from baseline.Additional end points included a decrease in the estimated glomerular filtration rate of >25% at 48 hours.Postprocedure acute renal failure was defined as a rapid decrease in renal glomerular filtration with a >176.8 umol/L (2 mg/dl) creatinine increase from baseline. CK-MB and cTnI were measured at admission ,the day of PCI and 24 after PCI.Results the baseline data and the total contrast volume(A20 172.81±59.18 vs A40 186.86±61.81,P >0.05)used during the procedure were not significantly different statistically between the 2 groups. comparison with the baseline levels,In both groups urinaryα1-MG and cystatin C significantly increased at day 1 after PCI(P<0.05),but Ccr and GFR significantly decreased at the same time(P<0.05).in comparison to the levels at day 1 after PCI, urinaryα1-MG and cystatin C significantly decreased at day 2 after PCI(P<0.05),but Ccr and GFR significantly increased at the same time(P<0.05).Andα1-MG, cystatin C, Ccr and GFR recovered to baseline levels at day 2 after PCI (P >0.05). comparison with the baseline levels,hsCRP significantly increased at day 1 after PCI(P<0.05)In both groups. in comparison to the levels at day 1 after PCI, hsCRP level had no significant change at day 2 after PCI(P >0.05).Compared with A20,from clinic data A40 further protected renal function and reduced inflammation trendly, but the difference did not reach statistical significant(P >0.05). The incidence of CIN was 2.5% in A20 group,while the incidence of CIN was not found in A40 group.The peak levels of marks of CK-MB and cTnI were increased significantly in both groups after PCI. There were significant differences on the two items between groups (P<0.05). But compared with A20,from clinic data A40 further protected myocardial trendly, but the difference did not reach statistical significant(P >0.05). Conclusions Pretreatment with atorvastatin for 2 to 3 days could significantly improved renal function caused by contrast agent and myocardial damage in patients with ACS undergoing PCI, which is related to the anti-inflammation.