Elective PCI may be complicated with elevation of cardiac biomarkers. Several studies suggested that pretreatment with statins may be associated with a reduction in periprocedural myocardial necrosis.
Three hundred and fifty patients with stable angina who underwent elective PCI were randomly assigned to receive a pre-procedural reloading dose of Rosuvastatin (40 mg) (Rosuvastatin Group¡ªRG n = 175) or Atorvastatin (80 mg) (Atorvastatin Group¡ªAG n = 175) and a control group on chronic statin therapy without reloading (Control-Group¡ªCG). The primary end-point was periprocedural myocardial necrosis and the occurrence of MACCE at 30-day,6-12 month follow-up. Also we evaluate the rise of periprocedural Troponin T serum levels > 3 ¡Á the upper limit of normal.
Twelve and 24-hour post-PCI Creatine Kinase Muscle and Brain (CK-MB) elevation > 3 ¡Á occurred more frequently in the CG than in the RG and in the AG (at 24-h: 25.0 vs 7.1; p = 0.003 and 25.0 vs 6.1; p = 0.001). At 30-day, 6-and 12-month follow-up the incidence of cumulative MACCE was higher in CG than in the RG or AG (at 12-month: 41.0 % vs 11.4 % vs 12.0 % ; p = 0.001). There was no difference between the RG and AG in terms of myocardial post-procedural necrosis and MACCE occurrence at follow-up.
High-dose statin reloading improves procedural and long term clinical outcomes in stable patients on chronic statin therapy. Both Rosuvastatin and Atorvastatin showed similar beneficial effects on procedural and long-term outcomes.