Journal Article

Anti-Oxidative Stress Effect of Loading-Dose Rosuvastatin Prior to Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome: A Prospective Randomized Controlled Clinical Trial

Zhang, Ran, Cao, Feng, Zhang, Xiaotian, Yan, Wei, Zhang, Qian, Chen, Yundai, Liang, Dong, Wang, Jinda, Yang, Hexu, Gao, Haokao

2014

Overview

Background and Objectives Administration of a loading dose of a statin (HMG-CoA reductase inhibitor) prior to percutaneous coronary intervention (PCI) contributes to protection from myocardial ischemic–reperfusion injury. This trial was designed to investigate the effect and mechanism of loading-dose rosuvastatin therapy before PCI in patients with acute coronary syndrome. Methods One hundred and forty-three patients with acute coronary syndrome were randomized to either the loading-dose (rosuvastatin 40 mg given 4 h before PCI) or conventional-dose (rosuvastatin 10 mg given 4 h before PCI) group. Blood samples were collected before and 0, 24, and 72 h post-PCI for measurement of serum cardiac troponin-I (cTn I), creatine kinase-MB (CK-MB), superoxide dismutase (SOD), reactive oxygen species (ROS), and malondialdehyde (MDA). Echocardiography and the major adverse cardiac/cerebrovascular events (MACCE) rate were followed up for 6 months post-PCI. Results Blood serum CK-MB and cTn I were significantly lower in the loading-dose group than in the conventional-dose group at 24 and 72 h post-PCI [CK-MB: 26.90 ± 3.22 vs. 32.96 ± 2.65 IU/L, P  = 0.024; 10.79 ± 4.65 vs. 15.18 ± 5.39 IU/L, P  = 0.021. cTn I: 0.046 ± 0.007 vs. 0.055 ± 0.002 ng/mL, P  = 0.015; 0.027 ± 0.006 vs. 0.041 ± 0.006 ng/mL, P  = 0.026]. Echocardiography at 6 months after PCI revealed significant improvement in cardiac function in the loading-dose group compared with the conventional-dose group ( P  < 0.05). The MACCE rate at 6 months after PCI in the loading-dose group was lower than in the conventional-dose group ( P  = 0.0428). The levels of MDA and ROS were decreased and the SOD level was significantly higher in the loading-dose group than in the conventional-dose group at 0, 24, and 72 h post-PCI ( P  < 0.05). Conclusion Administration of loading-dose rosuvastatin in patients with acute coronary syndrome prior to PCI exerts myocardial protection by inhibition of oxidative stress.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Acute Coronary Syndrome - drug therapy / Acute Coronary Syndrome - surgery / Administration, Oral / Creatine Kinase, MB Form - blood / Drug Administration Schedule / Female / Fluorobenzenes - administration & dosage / Fluorobenzenes - pharmacology / Fluorobenzenes - therapeutic use / Humans / Internal Medicine / Male / Medicine / Medicine & Public Health / Middle Aged / Original Research Article / Oxidative Stress - drug effects / Percutaneous Coronary Intervention / Pharmacology/Toxicology / Pharmacotherapy / Prospective Studies / Pyrimidines - administration & dosage / Pyrimidines - pharmacology / Pyrimidines - therapeutic use / Rosuvastatin Calcium / Sulfonamides - administration & dosage / Sulfonamides - pharmacology / Sulfonamides - therapeutic use / Troponin I - blood