Prevention of acute myocardial damage by loading doses of statins in elective percutaneous coronary interventions

The open, prospective, randomized comparative study included 68 patients who underwent successful elective endovascular intervention for atherosclerosis-related coronary artery stenosis. At baseline, all patients were taking statins as the standard lipid-lowering therapy long-term. Group 1 included 33 patients who received a loading dose of atorvastatin 80 mg 12 hours before the intervention and the same dose for 2 days with consequent reduction to the standard dose. Average total dose per patient was 320 (260-400) mg for 7 days of hospital stay. Group 2 included 35 patients treated with rosuvastatin 40 mg/day or 260 (240-280) mg for 7 days of hospital stay. The levels of cardiac biomarkers TnI and CK MB were determined at baseline, 12, 24, 48, and 72 hours after PCI. The study demonstrated that the use of high loading doses of potent statins (atorvastatin and rosuvastatin) with planned endovascular interventions on the coronary arteries had a similar impact on the dynamics of cardiac bio-markers during 72 hours after PCI. The use of a loading dose of rosuvastatin had an advantage due to significantly smaller increases in CK MB and TnI (26.7% and 27.1%, respectively) during the first 12 hours after the procedure, 24.3%-decrease in the number of patients with more than 1 x ULN TnI level, and due to 12.1%-decrease in the number of patients with increased CPK MB more than 3 x ULN after the procedure. These observations suggest less acute myocardial damage during the intervention in patients receiving a loading dose of rosuvastatin compared with those receiving a loading dose of atorvastatin.