Department of Pharmacy, University Health System, San Antonio, TX, USA.
J Cardiovasc Pharmacol Ther. 2011 Sep-Dec;16(3-4):376-9. doi: 10.1177/1074248410394362. Epub 2011 Mar 8.
Contrast-induced nephropathy (CIN) is associated with long-term morbidity, mortality, and increased health care costs. It has been suggested that statins have pleiotropic effects countering inflammatory and oxidative stress involved in CIN. Several studies support this theory; however, previously published studies have not evaluated the potential differences between statins in reducing the incidence of CIN. The purpose of this retrospective, single-center trial was to compare the incidence of CIN in patients receiving simvastatin or pravastatin therapy undergoing percutaneous coronary intervention (PCI). A total of 261 patients were included (145 received simvastatin and 116 received pravastatin) with the majority undergoing elective PCI. The population was predominantly male (65%), Hispanic (65%), and diabetic (62%), with a mean age of 59 years and a low-density lipoprotein (LDL) of 85 mg/dL. No significant differences were found between groups for risk factors or prophylactic strategies (eg, hydration). Contrast-induced nephropathy occurred in 26 patients (17.9%) in the simvastatin group versus 10 (8.6%) in the pravastatin group (P < .05). No patients required dialysis as a result of contrast administration. Acute kidney injury (AKI) occurred in 21 patients (14.5%) in the simvastatin group compared to 8 (6.9%) in the pravastatin group (P < .05). In multivariate analysis, the difference between statins remained an independent predictor for the development of CIN. In conclusion, patients on pravastatin had a significantly lower incidence of CIN compared to patients on simvastatin.
对比剂肾病（CIN）与长期发病率、死亡率和增加的医疗保健费用有关。有人认为他汀类药物具有抗 CIN 相关炎症和氧化应激的多效作用。几项研究支持这一理论；然而，以前发表的研究并未评估他汀类药物在降低 CIN 发生率方面的潜在差异。本回顾性单中心试验的目的是比较接受辛伐他汀或普伐他汀治疗的经皮冠状动脉介入治疗（PCI）患者的 CIN 发生率。共有 261 例患者入组（145 例接受辛伐他汀治疗，116 例接受普伐他汀治疗），其中大部分接受择期 PCI。该人群主要为男性（65%）、西班牙裔（65%）和糖尿病患者（62%），平均年龄为 59 岁，低密度脂蛋白（LDL）为 85mg/dL。两组患者的危险因素或预防策略（如水化）无显著差异。辛伐他汀组 26 例（17.9%）发生 CIN，普伐他汀组 10 例（8.6%）发生 CIN（P<0.05）。无患者因造影剂使用而需要透析。辛伐他汀组 21 例（14.5%）发生急性肾损伤（AKI），普伐他汀组 8 例（6.9%）发生 AKI（P<0.05）。多变量分析显示，他汀类药物之间的差异仍然是 CIN 发展的独立预测因素。总之，与辛伐他汀相比，普伐他汀组患者 CIN 的发生率显著降低。
