Cardiology Xagena

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Acute coronary syndromes: effect of a single high loading dose of Rosuvastatin on percutaneous coronary intervention

A high loading dose of Atorvastatin ( Lipitor ) has been confirmed to reduce postprocedural events in patients undergoing percutaneous coronary intervention ( PCI ).
In this study, researchers sought to investigate the protective effects of Rosuvastatin ( Crestor ) in patients with acute coronary syndromes ( ACS ) undergoing PCI and to determine the effect of Rosuvastatin pretreatment on the postprocedural levels of high-sensitivity C-reactive protein ( hs-CRP ), interleukin 6 ( IL-6 ), and monocyte chemotactic protein 1 ( MCP-1 ).

A total of 125 patients with non-ST-segment elevation acute coronary syndrome were randomized to pretreatment with Rosuvastatin ( 20 mg 2-4 hours before PCI [ n = 62 ] ) or placebo ( n = 63 ).
All the patients received subsequent long-term Rosuvastatin treatment ( 10 mg/d ).

The main end point of the trial was the 30-day incidence of major adverse cardiac events ( death, myocardial infarction, or unplanned revascularization ).

Plasma levels of hs-CRP, IL-6, and MCP-1 were detected before PCI and 6 hours, 24 hours, and 3 days after PCI.

The primary end point occurred in 8.1% of the patients in the Rosuvastatin arm and 22.2% in the placebo arm ( P less than 0.01 ); this difference was entirely attributed to a reduced incidence of myocardial infarction ( 8.1% vs 22.2%; P less than 0.01 ).

The postprocedural elevation in creatine kinase-MB and troponin I was also significantly lower in the Rosuvastatin group at 6 hours, 24 hours, and 3 days.

Plasma levels of hs-CRP, IL-6, and MCP-1 increased significantly after PCI in both the Rosuvastatin and control groups; however, the postprocedural elevations in hs-CRP and IL-6 levels were significantly lower in the Rosuvastatin group than the control group.

In conclusion, a single, high dose ( 20 mg ) of Rosuvastatin prior to PCI reduces postprocedural myocardial injury in patients with acute coronary syndrome, with a concomitant attenuation of the postprocedural increase in hs-CRP and IL-6 levels. ( Xagena )

Wang Z et al, J Cardiovasc Pharmacol Ther 2013;18:327-333