Influence of Loading Dose Of Atorvastatin on the Risk of Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction

Aim This retrospective cohort study focused on evaluating the incidence of contrast-induced nephropathy (CIN) associated with administration of an atorvastatin loading dose (80 mg) prior to invasive coronary angiography (CAG) in patients with ST-segment elevation myocardial infarction (STEMI).M...

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Bibliographic Details
Published in:	Kardiologiia Vol. 63; no. 2; p. 34
Main Authors:	Gavrilko, A D, Mezhonov, E M, Shalaev, S V, Abdullaev, D E Ogly, Shermuk, A A, Kuslivyi, A M, Krasheninin, D V, Vyalkina, Yu A
Format:	Journal Article
Language:	English Russian
Published:	Russia (Federation) 28-02-2023
Subjects:	Atorvastatin - administration & dosage Contrast Media - adverse effects Creatinine Humans Kidney Diseases - chemically induced Kidney Diseases - diagnosis Retrospective Studies ST Elevation Myocardial Infarction - diagnosis
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Summary:	Aim This retrospective cohort study focused on evaluating the incidence of contrast-induced nephropathy (CIN) associated with administration of an atorvastatin loading dose (80 mg) prior to invasive coronary angiography (CAG) in patients with ST-segment elevation myocardial infarction (STEMI).Material and methods This retrospective cohort study included 386 patients with STEMI. The patients were divided into two groups: intervention group (n=118) and control group (n=268). Patients in the intervention group, at the stage of admission to the catheterization laboratory, were administered a loading dose of atorvastatin (80 mg, p.o.) immediately before access (introducer placement). The endpoints were development of CIN, which was determined by increased serum creatinine 48 h following the intervention by at least 25% (or 44 µmol/l) of baseline value. In addition, in-hospital mortality and incidence of CIN resolution were assessed. To adjust the groups for dissimilar characteristics, a "pseudorandomization" method was used by comparing propensity scores.Results The incidence of CIN was significantly lower in the intervention group than in the control group (10.5 % vs. 24.4 %; p=0.016) with the odds for the CIN development lower than in the control group (odds ratio (OR) 0.36; 95 % confidence interval (CI), 0.16-0.85). Creatinine concentrations returned to the baseline value in 7 days more frequently than in the control group (66.3 % vs. 50.6 %, respectively; OR, 1.92; 95 % CI, 1.04-3.56; p=0.037). In-hospital mortality was higher in the control group but did not differ significantly between the groups.Conclusion ~Administration of atorvastatin 80 mg to STEMI patients immediately before CAG was associated with a reduced risk of CIN and a higher likelihood of serum creatinine returning to the values at admission by day 7.
ISSN:	0022-9040
DOI:	10.18087/cardio.2023.2.n2080