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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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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