Effect of Rosuvastatin Therapy on Troponin I Release Following Percutaneous Coronary Intervention in Nonemergency Patients (from the TIP 3 Study)

Several randomized studies have suggested that pretreatment with statins may reduce a periprocedural biomarker release in patients who underwent percutaneous coronary intervention (PCI); however, results remain controversial. The purpose of this study was to investigate the effect of a 1-day rosuvas...

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Bibliographic Details
Published in:The American journal of cardiology 2014-02, Vol.113 (3), p.446-451
Main Authors: Veselka, Josef, MD, PhD, Hájek, Petr, MD, Tomašov, Pavol, MD, Tesař, David, MD, PhD, Brůhová, Hana, MD, Matějovič, Martin, MD, PhD, Branny, Marian, MD, Studenčan, Martin, MD, PhD, Zemánek, David, MD, PhD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Cardiovascular
Cholesterol
Coronary Artery Disease - blood
Coronary Artery Disease - drug therapy
Coronary Artery Disease - surgery
Coronary vessels
Disease Progression
Dose-Response Relationship, Drug
Drug therapy
Female
Fluorobenzenes - administration & dosage
Follow-Up Studies
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Male
Middle Aged
Percutaneous Coronary Intervention
Postoperative Period
Pyrimidines - administration & dosage
Rosuvastatin Calcium
Statins
Sulfonamides - administration & dosage
Treatment Outcome
Troponin I - blood
Troponin I - drug effects
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Summary:Several randomized studies have suggested that pretreatment with statins may reduce a periprocedural biomarker release in patients who underwent percutaneous coronary intervention (PCI); however, results remain controversial. The purpose of this study was to investigate the effect of a 1-day rosuvastatin therapy on troponin I release in patients who underwent nonemergency PCI. A total of 445 patients with angina pectoris were randomly assigned to therapy with rosuvastatin (20 mg 12 hours before coronary angiography + 20 mg immediately before PCI; rosuvastatin group, 220 patients) or PCI without statin therapy (control group, 225 patients). In patients taking statins (73%), rosuvastatin was added to their long-term statin therapy. The primary end point was the incidence of TnI microleak defined as TnI elevation >1.5× upper limit of normal, and the secondary end point was the incidence of post-PCI TnI elevation >3× upper limit of normal. The incidence of primary and secondary end point in the rosuvastatin versus control group was 13.6% versus 12% (p = 0.61) and 8.2% versus 7.1% (p = 0.67), respectively. Patients with C-reactive protein ≥2.0 mg/L had a decreased release of post-PCI TnI in the rosuvastatin group (0.032 [0.010 to 0.143] μg/L vs 0.056 [0.018 to 0.241] μg/L; p = 0.04). In conclusion, 1-day rosuvastatin therapy (20 mg twice a day) did not influence post-PCI TnI release in patients with angina. However, these results suggest that, in patients with an advanced inflammatory status, rosuvastatin loading therapy might have a cardioprotective effect.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.10.026