Cited by 238Coronary Interventions and DiagnosticsAcute Myocardial Infarction ResearchAntiplatelet Therapy and Cardiovascular Diseases

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Novel Approaches for Preventing or Limiting Events (Naples) II Trial

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Briguori, Carlo, Visconti, Gabriella, Focaccio, Amelia, Golia, Bruno, Chieffo, Alaide, Castelli, Alfredo, Mussardo, Marco, Montorfano, Matteo, Ricciardelli, Bruno, Colombo, Antonio·2009·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2009.07.005

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Abstract

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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Self-citation
Impact of Long-term Statin Therapy on Postprocedural Myocardial Infarction in Patients Undergoing Nonemergency Percutaneous Coronary Intervention
Gordin, J. S., Haider, A., Swaminathan, R. V., Kim, L. K., Minutello, R. M., Bergman, G. W., Wong, S. C., & Feldman, D. N. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.06.052 · Cited by 13
Efficacy and safety of serial atorvastatin load in Chinese patients undergoing elective percutaneous coronary intervention: results of the ISCAP (Intensive Statin Therapy for Chinese Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention) randomized controlled trial
Zheng, B., Jiang, J., Liu, H., Zhang, J. J., Li, H., Su, X., Wang, H., Song, Z., Han, Y., Lei, H., et al. (2015) · European Heart Journal Supplements · doi:10.1093/eurheartj/suv021 · Cited by 13

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
ORCID: Briguori, Carlo
Focaccio, Amelia
Chieffo, Alaide
Montorfano, Matteo
Colombo, Antonio
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)
DOI: 10.1016/j.jacc.2009.07.005
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: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1323 d)
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 › Cardiology and Cardiovascular Medicine › 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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