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Atorvastatin Pretreatment Linked to Better PCI Outcomes

Last Updated: July 02, 2009.

For patients on statin therapy, a high-dose atorvastatin reload before percutaneous coronary intervention was associated with a lower risk of major adverse cardiac events in the following 30 days, according to research published online July 1 in the Journal of the American College of Cardiology.

THURSDAY, July 2 (HealthDay News) -- For patients on statin therapy, a high-dose atorvastatin reload before percutaneous coronary intervention was associated with a lower risk of major adverse cardiac events in the following 30 days, according to research published online July 1 in the Journal of the American College of Cardiology.

Germano Di Sciascio, M.D., of the Campus Bio-Medico University of Rome, and colleagues analyzed data from 383 patients with stable angina or non-ST-segment elevation acute coronary syndromes who were on chronic statin therapy. Subjects were randomized to receive placebo or 80 milligrams of atorvastatin 12 hours before the procedure and another 40-milligram dose roughly two hours before the procedure.

The researchers found that the primary end point -- 30-day incidence of cardiac death, myocardial infarction, or unplanned revascularization -- was less likely in the treatment group (3.7 versus 9.4 percent). The difference was mainly due to reduced periprocedural myocardial infarction in the treatment group.

"Based upon the body of evidence, supported by the ARMYDA-RECAPTURE study results, it would seem virtually indisputable that pretreatment with statins benefits patients undergoing percutaneous coronary intervention. Likely, reloading is also beneficial, although the modest size of the present study precludes firm conclusions," write the authors of an accompanying editorial. "Clinicians perhaps can be excused for being slow to embrace this concept because of the assumption that all patients with coronary disease should already be on statins and because of lingering doubts regarding the significance of low levels of enzyme rise associated with percutaneous coronary intervention."

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