Abstract 13241: Short-term Loading of High Dose Statins Decreases Periprocedural Myocardial Infarction After Percutaneous Coronary Intervention
Background: Post-percutaneous coronary intervention (PCI) myocardial infarction (MI) has been associated with long-term incremental risk for mortality among patients with coronary artery disease. Recent evidence suggests that statins can reduce periprocedural MI after PCI through its pleiotropic properties. We performed a meta-analysis to assess the benefit of short-term loading of high dose statins in reducing periprocedural MI based on the elevation of cardiac biomarkers, and the occurrence of major adverse cardiac events (MACE).
Methods and Results: Only 5 randomized trials from our systematic search met the inclusion criteria, with pooled 1867 patients for elective or emergency PCI. The type and dose of statins varied, rosuvastatin 40mg (n=225) or atorvastatin 80 to 160mg (n=716) were given 2 to 48 hours at most before PCI. Four trials (n=1484) included patients with no history of statin intake prior to PCI. The risk ratio using a fixed effect model (with 95% confidence interval) showed that high dose statins significantly reduced CKMB and troponin elevation, and MACE after PCI, RR 0.54 95% CI (0.42, 0.69), RR 0.70 95% CI (0.61, 0.79) and RR 0.49 95% CI (0.37, 0.66), respectively.
Conclusions: Short-term loading of high dose statins is of benefit to patients for elective or emergency PCI, as it significantly reduces periprocedural MI and MACE. A. CKMB elevation
B. Troponin elevation
- © 2010 by American Heart Association, Inc.