Background The incidence of myocardial injury limits the clinical outcomes of percutaneous coronary intervention (PCI). This randomised controlled study was designed to evaluate the protective effects of pretreatment atorvastatin on myocardial injury and inflammatory reaction after PCI.
Methods 82 patients with chronic stable angina without previous statins treatment in 2 months before PCI were randomised to receive atorvastatin 10 mg/qn (group A, n=27), 20 mg/qn (group B, n=28) or 40mg/qn (group C, n=27) treatment for 3 days before PCI. CK-MB, cTnI, hsCRP, IL-6, sICAM-1 were measured at baseline, 8 and 24 h after the procedure. 1-month clinical follow-up was obtained by office visit in all patients.
Results The peak levels of CK-MB and cTnI were increased significantly in all three groups 24 h after PCI (all p<0.05). Either elevation above the upper normal limit (UNL) or >3×UNL of cTnI, there were significant differences between group A and B (p<0.05), and between group A and C (p<0.05), but no difference between group B and C (p>0.05). Similarly changes were also found in CK-MB. The level of IL-6, sICAM-1 and hsCRP 8 h after PCI were higher than those before PCI (all p<0.05). There were significant differences in IL-6 and hsCRP among the three groups (all p<0.05), but no significant difference in sICAM-1 (p>0.05). The level of hsCRP and sICAM-1 24 h after PCI were higher than those 8 h after PCI in all three groups (all p<0.05), but IL-6 significantly decreased (p<0.05). There were significant differences among the three groups (all p<0.05). No serious cardiovascular events occurred during follow-up.
Conclusion Even short term pretreatment with atorvastatin before PCI may reduce procedural myocardial injury by reducing inflammatory factors in chronic stable angina patients.