Randomized trial of statin administration for myocardial injury - Is intensive lipid-lowering more beneficial than moderate lipid-lowering before percutaneous coronary intervention?

Masayoshi Kinoshita, Shin Ichirou Matsumura, Kouichirou Sueyoshi, Satoshi Ogawa, Keiichi Fukuda

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy. Methods and Results: Subjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C) <70 mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C <100 mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial damage was 14.2% in Group A and 47.6% in Group B (p=0.043). CK-MB was above the upper limit of normal (ULN) in 19% of Group A and 33.3% of Group B (p=0.44), and CK-MB was >3xULN in 9.5% of Group A and 19% of Group B (p=0.66). Conclusions: Intensive lipid-lowering therapy before PCI reduces minor myocardial damage during PCI with stenting compared with moderate lipid-lowering therapy.

Original languageEnglish
Pages (from-to)1225-1228
Number of pages4
JournalCirculation Journal
Volume71
Issue number8
DOIs
Publication statusPublished - 2007

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Percutaneous Coronary Intervention
Lipids
Wounds and Injuries
Therapeutics
Stable Angina
LDL Cholesterol

Keywords

  • Angioplasty
  • Cholesterol
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Randomized trial of statin administration for myocardial injury - Is intensive lipid-lowering more beneficial than moderate lipid-lowering before percutaneous coronary intervention? / Kinoshita, Masayoshi; Matsumura, Shin Ichirou; Sueyoshi, Kouichirou; Ogawa, Satoshi; Fukuda, Keiichi.

In: Circulation Journal, Vol. 71, No. 8, 2007, p. 1225-1228.

Research output: Contribution to journalArticle

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abstract = "Background: Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy. Methods and Results: Subjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C) <70 mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C <100 mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial damage was 14.2{\%} in Group A and 47.6{\%} in Group B (p=0.043). CK-MB was above the upper limit of normal (ULN) in 19{\%} of Group A and 33.3{\%} of Group B (p=0.44), and CK-MB was >3xULN in 9.5{\%} of Group A and 19{\%} of Group B (p=0.66). Conclusions: Intensive lipid-lowering therapy before PCI reduces minor myocardial damage during PCI with stenting compared with moderate lipid-lowering therapy.",
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AU - Fukuda, Keiichi

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N2 - Background: Minor myocardial damage after percutaneous coronary intervention (PCI) is associated with cardiac risks, which statins seem to reduce. The aim of this study was to examine whether intensive lipid-lowering therapy is more effective in decreasing the risk of cardiac injury after PCI than moderate lipid-lowering therapy. Methods and Results: Subjects comprised 42 patients with stable angina without previous statin treatment, randomly assigned to either an intensive lipid-lowering group (Group A: target low-density lipoprotein-cholesterol (LDL-C) <70 mg/dl) or a moderate lipid-lowering group (Group B: target LDL-C <100 mg/dl) 2 weeks before PCI. All patients took statins to reach target LDL-C levels. Incidence of periprocedural myocardial injury was assessed by analyzing levels of creatine kinase myocardial isozyme (CK-MB) and cardiac troponin T (TnT) before and 6, 12 and 24 h after PCI. Minor myocardial damage was defined as TnT elevation to >0.01 ng/ml. Frequency of minor myocardial damage was 14.2% in Group A and 47.6% in Group B (p=0.043). CK-MB was above the upper limit of normal (ULN) in 19% of Group A and 33.3% of Group B (p=0.44), and CK-MB was >3xULN in 9.5% of Group A and 19% of Group B (p=0.66). Conclusions: Intensive lipid-lowering therapy before PCI reduces minor myocardial damage during PCI with stenting compared with moderate lipid-lowering therapy.

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