Coronary artery diseaseShort-Term, High-Dose Atorvastatin Pretreatment to Prevent Contrast-Induced Nephropathy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention (from the ARMYDA-CIN [Atorvastatin for Reduction of MYocardial Damage during Angioplasty–Contrast-Induced Nephropathy] Trial
Section snippets
Methods
The ARMYDA-CIN trial (Figure 1) is a randomized, multicenter, prospective, double-blind clinical trial performed in 2 Italian institutions (Campus Bio-Medico, University of Rome and Vito Fazzi Hospital, Lecce). Statin-naive patients with non–ST-segment elevation ACS (unstable angina or non–ST-segment elevation myocardial infarction) and a planned invasive strategy within 48 hours were included. Exclusion criteria were current or previous (<3 months) statin treatment, non–ST-segment elevation
Results
Clinical and procedural characteristics were similar in the 2 arms and are presented in Table 1, Table 2, respectively. In particular, the proportion of diabetes mellitus was 30% in the atorvastatin and 25% in the placebo group (p = 0.64), and that of chronic renal failure was 29% and 32% (p = 0.71); baseline serum creatinine and CrCl values were 1.04 ± 0.32 versus 1.04 ± 0.22 mg/dl (p = 0.96) and 79.8 ± 29.4 versus 77.0 ± 27.6 ml/min (p = 0.45), respectively. Mean time from admission to
Discussion
The randomized placebo-controlled ARMYDA-CIN trial demonstrates that short-term pretreatment with high-dose atorvastatin significantly decreases the occurrence of CIN in statin-naive patients with ACS receiving early PCI.
The incidence of CIN differs widely across published studies depending on patients' risk profile and prevalence of factors potentially predisposing to such complication such as advanced age, diabetes mellitus, congestive heart failure, and pre-existing impaired renal function.1
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