Contrast-induced nephropathy (CIN) is associated with increased morbidity, extended hospital stay, and higher costs. We compared an atorvastatin plus N-acetylcysteine (NAC) regimen with NAC alone in patients undergoing coronary angiography. A total of 130 patients (mean age 54 ± 10; 77 men) undergoing coronary angiography were studied. Seven CIN cases occurred in the NAC group and 2 in the atorvastatin + NAC group; this difference was not significant. Baseline mean creatinine and estimated glomerular filtration rate (eGFR) were similar between the 2 groups, whereas after the procedure there was a significant creatinine decrease and eGFR increase in the atorvastatin + NAC group. Change in creatinine (baseline creatinine—creatinine after the procedure) was also significantly higher in patients taking statin plus NAC. Atorvastatin may be effective in protecting patients undergoing coronary angiography from CIN.
Jo SH, Koo BK, Park JS, et al. Prevention of radiocontrast medium-induced nephropathy using short-term high-dose simvastatin in patients with renal insufficiency undergoing coronary angiography (PROMISS) trial-a randomized controlled study. Am Heart J. 2008;155(3):499.e1-499.e8.
2.
McCullough PA , Wolyn R., Rocher LL, Levin RN, O’Neill WWAcute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997;103(5):368-375.
3.
Tepel M., van der Giet M., Schwarzfeld C., Laufer U., Liermann D., Zidek W.Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med. 2000;343(3):180-184.
Gueler F., Rong S., Park JK, et al. Postischemic acute renal failure is reduced by short-term statin treatment in a rat model. J Am Soc Nephrol. 2002;13(9):2288-2298.
6.
Khanal S., Attallah N., Smith DE, et al. Statin therapy reduces contrast-induced nephropathy: an analysis of contemporary percutaneous interventions. Am J Med. 2005;118(8):843-849.
7.
Attallah N., Yassine L., Musial J., Yee J., Fisher K.The potential role of statins in contrast nephropathy. Clin Nephrol. 2004; 62(4):273-278.
8.
Cockcroft DW, Gault MHPrediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41.
Lameire N., Van Biesen W., Vanholder R.Acute renal failure. Lancet. 2005;365(9457):417-430.
11.
Tepel M., Aspelin P., Lameire N.Contrast-induced nephropathy: a clinical and evidence-based approach. Circulation. 2006;113(14): 1799-1806.
12.
Liu R., Nair D., Ix J., Moore DH, Bent S.N-Acetylcysteine for the prevention of contrast-induced nephropathy: a systematic review and meta-analysis. J Gen Intern Med. 2005;20(2): 193-200.
13.
Duong MH, Mackenzie TA, Malenka DJN-Acetylcysteine prophylaxis significantly reduces the risk of radiocontrast-induced nephropathy: comprehensive meta-analysis. Catheter Cardiovasc Interv. 2005;64(4):471-479.
14.
Patti G., Nusca A., Chello M., et al. Usefulness of statin pretreatment to prevent contrast-induced nephropathy and to improve long-term outcome in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2008;101(3):279-285.
15.
Wassmann S. , Faul A., Hennen B., Scheller B., Böhm M., Nickenig G.Rapid effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibition on coronary endothelial function. Circ Res. 2003;93(9):e98-e103.
16.
Schaefer EJ , McNamara JR, Asztalos BF, et al. Effects of atorvastatin versus other statins on fasting and postprandial C-reactive protein and lipoprotein-associated phospholipase A2 in patients with coronary heart disease versus control subjects . Am J Cardiol. 2005;95(9):1025-1032.
17.
Xinwei J., Xianghua F., Jing Z., et al. Comparison of usefulness of simvastatin 20 mg versus 80 mg in preventing contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Am J Cardiol.2009; 104(4):519-524.
18.
Yoshida S., Kamihata H., Nakamura S., et al. Prevention of contrast-induced nephropathy by chronic pravastatin treatment in patients with cardiovascular disease and renal insufficiency . J Cardiol.2009;54(2):192-198.
19.
Goldenberg I., Matetzky S.Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. Can Med Assoc. J. 2005;172(11):1461-1471.
20.
Bonetti PO, Lerman LO, Napoli C., Lerman A.Statin effects beyond lipid lowering are they clinically relevant? Eur Heart J. 2003;24(3):225-248.
21.
Chello M., Goffredo C., Patti G., et al. Effects of atorvastatin on arterial endothelial function in coronary bypass surgery. Eur J Cardiothorac Surg. 2005;28(6):805-810.
22.
Lecian D., Demova H., Lodererova A., et al. Renal effects of HMGCoA reductase inhibition in a rat model of chronic inhibition of nitric oxide synthesis. Kidney Blood Press Res. 2006;29(3):135-143.
23.
Zhou X., Jin YZ, Wang Q., Min R., Zhang XYEfficacy of high dose atorvastatin on preventing contrast-induced nephropathy in patients underwent coronary angiography [in Chinese]. Zhonghua Xin Xue Guan Bing Za Zhi.2009;37(5):394-396.
