Impact of high dose versus low dose atorvastatin on contrast induced nephropathy in diabetic patients with acute coronary syndrome undergoing early percutaneous coronary intervention

摘要

Background Statins with its anti-inflammatory and pleiotropic effects may prevent contrast induced nephropathy in high risk diabetic patients. Aim of work To compare between the effects of high and low dose atorvastatin on preventing contrast induced nephropathy after early coronary intervention in diabetic patients with acute coronary syndrome. Patients and methods The study included 80 consecutive diabetic patients presented with acute coronary syndrome and with normal renal function or with mild renal impairment (creatinine clearance 60–90 ml/min) who underwent early percutaneous coronary intervention. Patients were randomly assigned to one of two groups, Group (A) 40 patients who received 80 mg atorvastatin 12 h and 40 mg just before PCI. Group (B) 40 patients who received 10 mg atorvastatin at the same time points. Samples were taken for serum creatinine and creatinine clearance before, at 12 h and at 72 h after PCI. Multivariable regression analysis did not identify any independent predictor of CIN. Results There were 5 cases of CIN in group A (12.5%) versus 7 in group B (17.5%), ( p 0.05). The incidence of post-PCI contrast-induced nephropathy was not significantly different between the study groups ( p 0.05). Univariate regression analysis identified baseline blood urea ( p = 0.012), blood urea after 12 h ( p = 0.030), and blood urea after 72 h ( p = 0.003) as predictors of CIN. Conclusion No significant difference between high and low doses of atorvastatin in preventing CIN in diabetic patients with normal or mild renal impairment presenting with acute coronary syndrome who underwent early PCI.