Golshani Samad, Tavasoli Parastoo, Farsavian Ali Asghar, Farsavian Hossein, Charati Jamshid Yazdani
Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Sari, Iran.
Department of Vascular Surgery, Mazandaran University of Medical Sciences, Sari, Iran.
J Family Med Prim Care. 2022 May;11(5):1957-1962. doi: 10.4103/jfmpc.jfmpc_1344_21. Epub 2022 May 14.
Contrast-induced nephropathy (CIN) is associated with increased disability and death. Randomized clinical trial studies have shown that short-term treatment with statins prior to cardiac intervention was capable of reducing the incidence of CIN. Therefore, the aim of this study was to compare the incidence of CIN after primary PCI in patients receiving high-dose rosuvastatin and atorvastatin.
This clinical trial was performed in Mazandaran Heart Center Hospital on patients referred to the emergency department who underwent primary PCI with a diagnosis of STEMI. Patients received 1 cc/kg/h normal saline from PCI for up to 12 hours. Patients with EF less than or equal to 35% received intravenous normal saline at half the usual dose. SPSS software version 24 was used for data analysis. value less than 0.05 was considered to be statistically significant.
206 patients were included in the study that the most underlying diseases of patients (79, 38.3%) were hypertension, followed by anemia (76, 36.9%) and diabetes mellitus (52, 25.2%). Among these, in the first criterion, 10 (8.1%) and 4 patients (4.8%) were in the atorvastatin and rosuvastatin groups, respectively, which did not have a statistically significant difference (P = 0.264). Examination of GFR subgroups also showed that GFR above 30 had significant differences between the two groups.
The use of different statins has had similar results in the prevention of CIN in patients undergoing primary PCI. Rosuvastatin has no special advantage over atorvastatin, showing that the use of any of these drugs can be useful in patients requiring angiography.
对比剂肾病（CIN）与残疾和死亡风险增加相关。随机临床试验研究表明，心脏介入术前短期使用他汀类药物能够降低CIN的发生率。因此，本研究旨在比较接受大剂量瑞舒伐他汀和阿托伐他汀的患者在直接经皮冠状动脉介入治疗（PCI）后CIN的发生率。
本临床试验在马赞德兰心脏中心医院对因ST段抬高型心肌梗死（STEMI）诊断而到急诊科就诊并接受直接PCI的患者进行。患者从PCI开始接受1 cc/kg/h的生理盐水输注，持续12小时。射血分数（EF）小于或等于35%的患者接受通常剂量一半的静脉生理盐水输注。使用SPSS 24版软件进行数据分析。P值小于0.05被认为具有统计学意义。
206例患者纳入本研究，患者最常见的基础疾病为高血压（79例，38.3%），其次是贫血（76例，36.9%）和糖尿病（52例，25.2%）。其中，在第一个标准中，阿托伐他汀组和瑞舒伐他汀组分别有10例（8.1%）和4例（4.8%）患者，差异无统计学意义（P = 0.264）。肾小球滤过率（GFR）亚组检查也显示，两组之间GFR高于30时有显著差异。
在接受直接PCI的患者中，使用不同他汀类药物预防CIN的结果相似。瑞舒伐他汀相对于阿托伐他汀没有特殊优势，表明使用这些药物中的任何一种对需要进行血管造影的患者都可能有用。
