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High- vs. low-dose statins reduced MIs at time of stenting
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PCI-related periprocedural MI was reduced more effectively by high-dose rosuvastatin than low-dose rosuvastatin in statin-naive patients, whereas low-dose rosuvastatin is sufficient for patients who are already taking statins, according to study results.
To investigate whether PCI-related periprocedural MI can be suppressed more significantly with high-dose rosuvastatin compared with low-dose rosuvastatin, researchers randomly assigned, in a 1:1 ratio, patients (n=232) with stable CAD who were scheduled to undergo elective PCI within 5 to 7 days into groups that would receive either 2.5 mg/day (the standard dose in Japan) or 20 mg/day (the highest approved dose) of rosuvastatin.
Periprocedural MI incidence did not significantly differ between groups (high dose, 8.7% vs. low dose, 18.7%; P=.052). However, high-dose rosuvastatin compared with the low dose significantly suppressed periprocedural MI in patients not taking statins at the time of enrollment (10.5% vs. 30.0%; P=.037), but the difference was not significant in patients who were already taking statins (high dose, 7.6% vs. low dose, 10.6%; P=.582).
“We speculated that high-dose statin could reduce the incidence of periprocedural MI more than low-dose statin by stabilizing vulnerable plaque more effectively and rendering the myocardium more tolerant of ischemia. However, we did not find a significant difference in the incidence of either in-hospital death or periprocedural MI, although the difference in the incidence of MI almost reached significance,” the researchers wrote. “This was most likely due to the inability of high-dose rosuvastatin to confer a protective effect upon patients who were already receiving statin treatment.”
Disclosure: The researchers report no relevant financial disclosures.
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