Effects of 80 mg loading dose atorvastatin pretreatment on myocardial protection during percutaneous coronary interventionin in elderly patients with non-ST-segment elevation acute coronary syndrome

Objective:This study was designed to evaluate the peri-procedural myocardial injury and safety profile of atorvastatin in patients over 70 years old with non-ST segment elevation acute coronary syndromes(NSTEACS). Method:A total of 157 patients over 70 years old with NSTEACS were randomly divided into the pretreatment with loading dose atorvastatin group or control atorvastatin group.The serum levels of creatine kinase-MB(CK-MB) and cardiac troponin I(cTnI) were measured at the baseline and at 8,12 and 24 h after the procedure.Clinical outcome was measured by taking the main end points of major adverse cardiac events including cardiac death,nonfatal acute myocardial infarction,or revascularization during 30 days follow-up. Result:The proportions of patients with the serum levels of CK-MB and cTnI above normal up-limit value and that with PCI-related myocardial infarction at 24 h were significantly lower in high dose atorvastatin group than those in the control dose group(37.9% vs 50.5%,P=0.002,5.4% vs 22.6%,P=0.041;12.6% vs 33.4%,P=0.035,4.3% vs 11.8%,P=0.034).At multivariable analysis,pre-treatment with atoravastatin conferred an 67% risk reduction of PCI-related myocardial infarction(P0.05).No deaths and revascularization were recorded at 30-day follow-up in both groups.Alanine aminotransferase has no difference in two groups. Conclusion:Short-term pretreatment with a high dose of atorvastatin significantly reduces PCI-related myocardial infarction in elderly patients with NSTEACS and enjoys similar safety profile.