Liu Yong, Liu Yuan-hui, Tan Ning, Chen Ji-yan, Zhou Ying-ling, Li Li-wen, Duan Chong-yang, Chen Ping-yan, Luo Jian-fang, Li Hua-long
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Southern medical university, Guangzhou, Guangdong, China.
PLoS One. 2014 Oct 30;9(10):e111124. doi: 10.1371/journal.pone.0111124. eCollection 2014.
We prospectively compared the preventive effects of rosuvastatin and atorvastatin on contrast-induced nephropathy (CIN) in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).
We enrolled 1078 consecutive patients with CKD undergoing elective PCI. Patients in Group 1 (n = 273) received rosuvastatin (10 mg), and those in group 2 (n = 805) received atorvastatin (20 mg). The primary end-point was the development of CIN, defined as an absolute increase in serum creatinine ≥0.5 mg/dL, or an increase ≥25% from baseline within 48-72 h after contrast medium exposure.
CIN was observed in 58 (5.4%) patients. The incidence of CIN was similar in patients pretreated with either rosuvastatin or atorvastatin (5.9% vs. 5.2%, p = 0.684). The same results were also observed when using other definitions of CIN. Clinical and procedural characteristics did not show significant differences between the two groups (p>0.05). Additionally, there were no significant inter-group differences with respect to in-hospital mortality rates (0.4% vs. 1.5%, p = 0.141), or other in-hospital complications. Multivariate logistic regression analysis revealed that rosuvastatin and atorvastatin demonstrated similar efficacies for preventing CIN, after adjusting for potential confounding risk factors (odds ratio = 1.17, 95% confidence interval, 0.62-2.20, p = 0.623). A Kaplan-Meier survival analysis showed that patients taking either rosuvastatin or atorvastatin had similar incidences of all-cause mortality (9.4% vs. 7.1%, respectively; p = 0.290) and major adverse cardiovascular events (29.32% vs. 23.14%, respectively; p = 0.135) during follow-up.
Rosuvastatin and atorvastatin have similar efficacies for preventing CIN in patients with CKD undergoing PCI.
我们前瞻性地比较了瑞舒伐他汀和阿托伐他汀对接受经皮冠状动脉介入治疗（PCI）的慢性肾脏病（CKD）患者造影剂肾病（CIN）的预防效果。
我们纳入了1078例连续接受择期PCI的CKD患者。第1组（n = 273）患者接受瑞舒伐他汀（10 mg），第2组（n = 805）患者接受阿托伐他汀（20 mg）。主要终点是CIN的发生，定义为造影剂暴露后48 - 72小时内血清肌酐绝对值增加≥0.5 mg/dL，或较基线水平增加≥25%。
58例（5.4%）患者发生CIN。接受瑞舒伐他汀或阿托伐他汀预处理的患者中CIN的发生率相似（5.9%对5.2%，p = 0.684）。使用CIN的其他定义时也观察到相同结果。两组的临床和手术特征无显著差异（p>0.05）。此外，两组在住院死亡率（0.4%对1.5%，p = 0.141）或其他住院并发症方面无显著组间差异。多因素逻辑回归分析显示，在调整潜在混杂危险因素后，瑞舒伐他汀和阿托伐他汀在预防CIN方面显示出相似的疗效（比值比 = 1.17，95%置信区间，0.62 - 2.20，p = 0.623）。Kaplan-Meier生存分析显示，服用瑞舒伐他汀或阿托伐他汀的患者在随访期间全因死亡率（分别为9.4%对7.1%；p = 0.290）和主要不良心血管事件发生率（分别为29.32%对23.14%；p = 0.135）相似。
瑞舒伐他汀和阿托伐他汀在预防接受PCI的CKD患者发生CIN方面具有相似疗效。
