Article Data

  • Views 169
  • Dowloads 6

Original Research

Open Access

Comparison of atorvastatin and rosuvastatin on preventing contrast-induced-nephropathy in patients undergoing primary percutaneous coronary intervention: A multi-centric randomized triple-blind clinical trial

  • Ramin Khameneh Bagheri1
  • Faeze Keihanian2,3
  • Ali Eshraghi4
  • Mostafa Ahmadi1
  • Hasan Amirsoleimani2

1Cardiology Department, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2Cardiology Department, Imam Reza & Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4Cardiology Department, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: 10.22514/sv.2020.16.0083 Vol.17,Issue 1,January 2021 pp.44-50

Published: 08 January 2021

*Corresponding Author(s): Mostafa Ahmadi E-mail: ahmadims@mums.ac.ir

Abstract

Background: Patients with Contrast-Induced-Nephropathy (CIN) are at a greater risk of in-hospital complications, longer hospitalization, and long-term mortality in comparison with those without CIN. Despite many studies on the helpful effects of statins in preventing contrast-nephropathy, there is not enough evidence comparing different statins in inhibiting CIN. So, we planned this study to compare the efficacy of rosuvastatin and atorvastatin in prevention of contrast-induced nephropathy. Methods: This was a randomized clinical trial. The efficacy of two known statins, atorvastatin and rosuvastatin were compared in prevention of CIN in patients with ST-Elevation Myocardial Infarction (STEMI) who underwent Primary Percutaneous Intervention (PPCI) between May 2015 and April 2016 in Qaem and Imam Reza hospital, Mashhad, Iran. Subjects were divided randomly to 80-mg atorvastatin or 40-mg rosuvastatin group before PPCI. Participants’ characteristics including echocardiographic, laboratory and demographic data were recorded and incidence of CIN was assessed. Results: Two hundred cases with STEMI undergoing PPCI were recruited in the study and randomized to 80-mg atorvastatin (n = 98) or 40-mg rosuvastatin (n = 102) group before PPCI. The incidence of CIN was 5.67% (n = 13) in all participants; 6.3% (n = 7) in the rosuvastatin group and 5.1% (n = 6) in the atorvastatin group. There was a significant difference between creatinine and Glomerular Filtration Rate (GFR) after 48 hours of PPCI. Creatinine was lower and GFR was higher in the rosuvastatin group (P = 0.029, P = 0.005). Conclusion: There was a little trend for prevention of CIN in patients after PPCI in rosuvastatin group compared to atorvastatin group, in full dose. However, this preference was not clinically relevant.

Keywords

Rosuvastatin; Atorvastatin; Primary percutaneous coronary intervention; ST elevation myocardial infarction

Cite and Share

Ramin Khameneh Bagheri,Faeze Keihanian,Ali Eshraghi,Mostafa Ahmadi,Hasan Amirsoleimani. Comparison of atorvastatin and rosuvastatin on preventing contrast-induced-nephropathy in patients undergoing primary percutaneous coronary intervention: A multi-centric randomized triple-blind clinical trial. Signa Vitae. 2021. 17(1);44-50.

References

[1] Marenzi G, Bartorelli AL. 27 contrast-induced nephropathy in patients undergoing primary angioplasty: Prognostic implications, prevention, and management. Mechanical Reperfusion for STEMI: From Random-ized Trials to Clinical Practice. 2016.

[2] Kapoor A, Gaur P. Contrast-induced nephropathy. Coronary Angioplasty: Evolved to Perfection. Jaypee Brothers Medical Publishers (P) Ltd. 2017.

[3] McCullough PA. Contrast-induced acute kidney injury. Journal of the American College of Cardiology. 2008; 51: 1419-1428.

[4] Grossman PM, Ali SS, Aronow HD, Boros M, Nypaver TJ, Schreiber TL, et al. Contrast-induced nephropathy in patients undergoing endovascular peripheral vascular intervention: Incidence, risk factors, and outcomes as observed in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. Journal of Interventional Cardiology. 2017; 30: 274-280.

[5] Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. circulation. 2002; 105: 2259-2264.

[6] Liss P, Persson P, Hansell P, Lagerqvist B. Renal failure in 57 925 patients undergoing coronary procedures using iso-osmolar or low-osmolar contrast media. Kidney International. 2006; 70: 1811-1817.

[7] Freeman RV, O’Donnell M, Share D, Meengs WL, Kline-Rogers E, Clark VL, et al. Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. The American Journal of Cardiology. 2002; 90: 1068-1073.

[8] Gurm HS, Dixon SR, Smith DE, Share D, LaLonde T, Greenbaum A, et al. Renal function-based contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions. Journal of the American College of Cardiology. 2011; 58: 907-914.

[9] Reed M, Meier P, Tamhane UU, Welch KB, Moscucci M, Gurm HS. The relative renal safety of iodixanol compared with low-osmolar contrast media: a meta-analysis of randomized controlled trials. JACC: Cardiovascular Interventions. 2009; 2: 645-654.

[10] Narula A, Mehran R, Weisz G, Dangas GD, Yu J, Généreux P, et al. Contrast-induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy. European Heart Journal. 2014; 35: 1533-1540.

[11] Senoo T, Motohiro M, Kamihata H, Yamamoto S, Isono T, Manabe K, et al. Contrast-induced nephropathy in patients undergoing emergency percutaneous coronary intervention for acute coronary syndrome. The American Journal of Cardiology. 2010; 105: 624-628.

[12] Verdoodt A, Honore PM, Jacobs R, De Waele E, Van Gorp V, De Regt J, et al. Do Statins Induce or Protect from Acute Kidney Injury and Chronic Kidney Disease: An Update Review in 2018. Journal of Translational Internal Medicine. 2018; 6: 21-25.

[13] Esmeijer K, Dekkers OM, de Fijter JW, Dekker FW, Hoogeveen EK. Effect of different types of statins on kidney function decline and proteinuria: a network meta-analysis. Scientific Reports. 2019; 9: 1-13.

[14] Farmer JA. Pleiotropic effects of statins. Current Atherosclerosis Reports. 2000; 2: 208-217.

[15] Wang N, Qian P, Yan TD, Phan K. Periprocedural effects of statins on the incidence of contrast-induced acute kidney injury: A systematic review and trial sequential analysis. International Journal of Cardiology. 2016; 206: 143-152.

[16] Thompson K, Razi R, Lee MS, Shen A, Stone GW, Hiremath S, et al. Statin use prior to angiography for the prevention of contrast-induced acute kidney injury: a meta-analysis of 19 randomised trials. EuroIntervention. 2016; 12: 366-374.

[17] Chyou AC, Thodge A, Feldman DN, Swaminathan RV. Statins in the prevention of contrast-induced nephropathy. Current Treatment Options in Cardiovascular Medicine. 2015; 17: 15.

[18] Kaya A, Kurt M, Tanboga IH, Işik T, Ekinci M, Aksakal E, et al. Ros uvastatin versus A torvastatin to prevent C ontrast I nduced N ephropathy in patients undergoing primary percutaneous coronary intervention (ROSA-CIN trial). Acta Cardiologica. 2013; 68: 489-494.

[19] Liu Y, Liu Y-h, Tan N, Chen J-y, Zhou Y-l, Li L-w, et al. Comparison of the efficacy of rosuvastatin versus atorvastatin in preventing contrast induced nephropathy in patient with chronic kidney disease undergoing percutaneous coronary intervention. PLoS One. 2014; 9: e111124.

[20] Harjai KJ, Raizada A, Shenoy C, Sattur S, Orshaw P, Yaeger K, et al. A comparison of contemporary definitions of contrast nephropathy in patients undergoing percutaneous coronary intervention and a proposal for a novel nephropathy grading system. The American Journal of Cardiology. 2008; 101: 812-819.

[21] Rear R, Bell RM, Hausenloy DJ. Contrast-induced nephropathy following angiography and cardiac interventions. Heart. 2016; 102: 638-648.

[22] Murphy SW, Barrett BJ, Parfrey PS. Contrast nephropathy. Journal of the American Society of Nephrology. 2000; 11: 177-182.

[23] Park SH, Jeong MH, Park IH, Choi JS, Rhee JA, Kim IS, et al. Effects of combination therapy of statin and N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary inter-vention. International Journal of Cardiology. 2016; 212: 100-106.

[24] Kandula P, Shah R, Singh N, Markwell SJ, Bhensdadia N, Navaneethan SD. Statins for prevention of contrast-induced nephropathy in patients un-dergoing non-emergent percutaneous coronary intervention. Nephrology. 2010; 15: 165-170.

[25] Toso A, Maioli M, Leoncini M, Gallopin M, Tedeschi D, Micheletti C, et al. Usefulness of atorvastatin (80 mg) in prevention of contrast-induced nephropathy in patients with chronic renal disease. The American Journal of Cardiology. 2010; 105: 288-292.

[26] Quintavalle C, Fiore D, De Micco F, Visconti G, Focaccio A, Golia B, et al. Impact of a high loading dose of atorvastatin on contrast-induced acute kidney injury. Circulation. 2012; 112: 103317.

[27] Hoshi T, Sato A, Kakefuda Y, Harunari T, Watabe H, Ojima E, et al. Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty: propensity score analysis from a multicenter registry. International Journal of Cardiology. 2014; 171: 243-249.

[28] Li W, Fu X, Wang Y, Li X, Yang Z, Wang X, et al. Beneficial effects of high-dose atorvastatin pretreatment on renal function in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention. Cardiology. 2012; 122: 195-202.

[29] Patti G, Cannon CP, Murphy SA, Mega S, Pasceri V, Briguori C, et al. Clinical benefit of statin pretreatment in patients undergoing percutaneous coronary interventionclinical perspective. Circulation. 2011; 123: 1622-1632.

[30] Leoncini M, Toso A, Maioli M, Tropeano F, Villani S, Bellandi F. Early high-dose rosuvastatin for contrast-induced nephropathy prevention in acute coronary syndrome: Results from the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome). Journal of the American College of Cardiology. 2014; 63: 71-79.

[31] Han Y, Zhu G, Han L, Hou F, Huang W, Liu H, et al. Short-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease. Journal of the American College of Cardiology. 2014; 63: 62-70.

[32] Toth PP. An update on the benefits and risks of rosuvastatin therapy. Postgraduate Medicine. 2014; 126: 7-17.

[33] Betteridge DJ, Gibson JM, Sager PT. Comparison of effectiveness of rosuvastatin versus atorvastatin on the achievement of combined C-reactive protein (< 2 mg/L) and low-density lipoprotein cholesterol (< 70 mg/dL) targets in patients with type 2 diabetes mellitus (from the ANDROMEDA study). The American Journal of Cardiology. 2007; 100: 1245-1248.

[34] Ridker PM, MacFadyen J, Cressman M, Glynn RJ. Efficacy of rosuvastatin among men and women with moderate chronic kidney disease and elevated high-sensitivity C-reactive protein: a secondary analysis from the JUPITER (Justification for the Use of Statins in Prevention–an Intervention Trial Evaluating Rosuvastatin) trial. Journal of the American College of Cardiology. 2010; 55: 1266-1273.

[35] Walldius G, Jungner I. Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy. Journal of Internal Medicine. 2004; 255: 188-205.

[36] Wong PCY, Li Z, Guo J, Zhang A. Pathophysiology of contrast-induced nephropathy. International Journal of Cardiology. 2012; 158: 186-192.

[37] Andò G, Morabito G, Gregorio C, Trio O, Saporito F, Oreto G. Age, glomerular filtration rate, ejection fraction, and the AGEF score predict contrast-induced nephropathy in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Catheterization and Cardiovascular Interventions. 2013; 82: 878-885.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

    Top