Prevention of acute myocardial damage in elective percutaneous coronary interventions

Data of many researchers suggest that the level of cardiac biomarkers indicating necrosis of cardiomyocytes increases during endovascular procedures on the coronary arteries. The risk of subsequent major cardiac events including death and myocardial infarction is associated with the degree of elevation of cardiac enzymes after surgery. Therefore, therapeutic strategies attenuating the frequency of procedural myocardial injury can have a positive impact on clinical outcomes after endovascular interventions. The authors demonstrated that the use of high loading doses of potent statins (atorvastatin and rosuvastatin) with a planned endovascular coronary intervention in patients who already receive standard lipidlowering therapy long-term, has a similar effect on the dynamics of cardiac biomarkers after PCI. At the same time, administration of a loading dose of rosuvastatin has an advantage due to a significantly smaller increase in the levels of creatine kinase-MB and TnI (26.7% and 27.1%, respectively) during the first 12 hours after the procedure. The second part of the work demonstrates that the addition of trimetazidine to standard therapy in endovascular revascularization in patients with impaired glucose metabolism reduces acute myocardial damage, although the clinical significance of the effect of that protection on remote patient outcomes requires more studies.