Novel Approaches for Preventing or Limiting Events (Naples) II Trial
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Objectives Atorvastatin administered at least 7 days before the percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (MI). It is unknown whether a single, high (80 mg) loading dose of atorvastatin may reduce the rate of periprocedural MI.Background Periprocedural MI is a prognostically important complication of PCI.Methods The day before the elective PCI, 668 statin-naive patients were randomly assigned to atorvastatin 80 mg (atorvastatin group; n = 338) or no statin treatment (control group; n = 330). Creatine kinase-myocardial isoenzyme (CK-MB) (upper limit of normal [ULN] 3.5 ng/ml) and cardiac troponin I (ULN 0.10 ng/ml) were assessed before and 6 and 12 h after the intervention. Periprocedural MI was defined as a CK-MB elevation >3x ULN alone or associated with chest pain or ST-segment or T-wave abnormalities.Results The incidence of a periprocedural MI was 9.5% in the atorvastatin group and 15.8% in the control group (odds ratio: 0.56; 95% confidence interval: 0.35 to 0.89; p = 0.014). Median CK-MB peak after PCI was 2.10 ng/ml (interquartile range 1.00 to 12.50 ng/ml) in the atorvastatin group and 3.20 ng/ml (interquartile range 1.37 to 16.07 ng/ml) in the control group (p = 0.014). The incidence of cardiac troponin I elevation >3x ULN was 26.6% in the atorvastatin group and 39.1% in the control group (odds ratio: 0.56; 95% confidence interval: 0.40 to 0.78; p < 0.001).Conclusions A single, high (80 mg) loading (within 24 h) dose of atorvastatin reduces the incidence of periprocedural MI in elective PCI.
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Cardiac rehabilitation programmes enhance control of lipid levels and improve overall survival following acute coronary syndrome.
“Ideally, patients should be signed up to cardiac rehabilitation programmes to enhance the control of lipid levels [434] and improve overall survival following ACS [435].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [435]
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- Authors
- Briguori, C., Visconti, G., Focaccio, A., Golia, B., Chieffo, A., Castelli, A., Mussardo, M., Montorfano, M., Ricciardelli, B., & Colombo, A.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- Clinica Mediterranea (IT)
- Corresponding author
- Briguori, Carlo
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 54
- Issue
- 23
- Pages
- 2157-2163
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W71404102
- Cited by
- 238
- References
- 32
- Citations by year
- 2025: 2 · 2024: 6 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 6 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 16 · 2015: 20 · 2014: 14 · 2013: 25 · 2012: 26
- FWCI
- 36.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- atorvastatin, periprocedural myocardial infarction, percutaneous coronary intervention, statin-naive patients, CK-MB, cardiac troponin I, ST segment abnormalities, T wave changes
- MeSH terms
- Atorvastatin, Aged, Dose-Response Relationship, Drug, Electrocardiography, Female, Heptanoic Acids, Humans, Male, Middle Aged, Myocardial Infarction, Pyrroles, Myocardial Reperfusion Injury, Angioplasty, Balloon, Coronary, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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