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Impacto na fun??o renal de uma dose de refor?o de rosuvastatina prévia a interven??o coronária percutanea eletiva nos pacientes em uso cr?nico de estatina

DOI: 10.1590/S2179-83972012000300014

Keywords: angioplasty, contrast media, statins, creatinine, kidney diseases.

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Abstract:

background: contrast-induced nephropathy (cin) is a potential complication after percutaneous coronary intervention (pci). the pathogenesis is associated to inflammatory mechanisms, endothelial dysfunction and oxidative stress and the use of statins, due to their pleiotropic effects, has been investigated in this setting. we assessed whether a preload dose of rosuvastatin prior to elective pci in patients on chronic statin reduces the incidence of cin. methods: prospective, randomized, open label, single-center study. patients were divided according to the use (group 1) or not (group 2) of rosuvastatin 40 mg, 2-6 hours prior to pci. the frequency of cin was compared between the two groups as well as in the diabetic and renal dysfunction subgroups. results: we included 135 patients, with 60.7 + 9.3 years of age, randomized to group 1 (n = 67) or group 2 (n = 68). the prevalence of diabetes was 31.1% and the prevalence of creatinine clearance < 60 ml/min was 13.3%. the incidence of cin was 8.1% and there was no difference between groups (9% vs. 7.4%; p = 0.89). the incidence of cin in diabetic patients was 15% vs. 13.6% (p = 0.75) and in those with renal dysfunction it was 12.5% vs. 0 (p = 0.93). conclusions: the use of a preload dose of rosuvastatin at its maximum dosage did not exert a protective effect in renal function of chronic statin users undergoing elective pci.

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