Comparing common doses (double-dose vs usual-dose) of atorvastatin for preventing contrast-induced acute kidney injury and mortality after coronary angiography.
Medicine (Baltimore)
; 96(30): e7501, 2017 Jul.
Article
en En
| MEDLINE
| ID: mdl-28746193
ABSTRACT
High-dose atorvastatin pretreatment was proved reducing the risk of contrast-induced acute kidney injury (CI-AKI), especially in patients with high C-reactive protein (CRP) levels. We evaluated the effects of common atorvastatin doses (double vs usual) on the risk of CI-AKI and mortality.We recorded outcomes from 1319 patients who were administered periprocedural common doses of atorvastatin. The risks of CI-AKI and mortality between double-dose (40âmg/d) and usual-dose atorvastatin (20âmg/d) were compared using multivariable regression models in all patients or CRP tertile subgroups.Seventy-six (5.8%) patients developed CI-AKI. Double-dose atorvastatin compared with usual-dose did not further reduce the risk of CI-AKI (adjusted odds ratio [OR] 2.28, 95% confidence interval [CI] 0.92-5.62, Pâ=â.074), even for patients in the highest CRP tertile (>8.33âmg/L; adjusted OR 3.76, 95% CI 0.83-17.05, Pâ=â.086). Similar results were observed in reducing mortality in all patients (adjusted hazard ratio 0.47, 95% CI 0.10-2.18; Pâ=â.339) and in the highest CRP tertiles (Pâ=â.424). In the subgroup analysis, double-dose atorvastatin increased risk of CI-AKI in patients with creatinine clearance (CrCl)â<â60âmL/min, anemia, contrast volumeâ>â200âmL andâ>â2 stents implanted (Pâ=â.046, .009, .024, and .026, respectively).Daily periprocedural double-dose atorvastatin was not associated with a reduced risk of CI-AKI compared with usual-dose, and did not provide an improved long-term prognosis, even in patients with high CRP levels. However, it increased the risk of CI-AKI in patients with a high contrast volume/CrCl.
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Base de datos:
MEDLINE
Asunto principal:
Angiografía Coronaria
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Medios de Contraste
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Sustancias Protectoras
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Lesión Renal Aguda
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Atorvastatina
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2017
Tipo del documento:
Article