Impact for Different Dose of Atorvastatin on Contrast-induced Nephropathy in Patients With High Level of hs-CRP After Percutaneous Coronary Intervention

Objective: To explore the impact for different dose of atorvastatin medication on contrast-induced nephropathy(CIN) in patients with high level of hs-CRP after percutaneous coronary intervention(PCI).Methods: A total of 700 patients who received PCI in our hospital from 2011-01 to 2012-06 were studied. The patients were divided into 2 groups, Intensive group, n=226, the patients received atorvastatin 40 mg/day at 24 h before to 72 h after PCI, and Routine group, n=474, the patients received atorvastatin 20 mg/day at 24 h before to 72 h after PCI. All patients had pre-operative hs-CRP 3 mg/L and without atorvastatin medication at 3 months before PCI. The serum levels of creatinine(Scr) and urea nitrogen(BUN) were examined at before and 48 h, 72 h after PCI. CIN was defined by elevated Scr 0.5 mg/dl or 25% within 48-72 h after contrast exposure. The CIN occurrence with MACE were compared between 2 groups.Results: CIN occurred in 100/700(14.3%) patients, the Intensive group and Routine group were similar(13.3% vs 14.8%, χ2=0.278, P=0.597), and the mortality(0.4% vs 0%, χ2=0. 96, P=0. 327), the incidence for requiring renalreplacement therapy(0.9% vs 0.4%, χ2=0.834, P=0.770), re-myocardial infarction(1.1% vs.0.4%, χ2=0. 682, P=0.409), acute heart failure(2.7% vs.2.1%, χ2=0.197, P=0. 658) were similar between 2 groups. Multivariate logistic regression analysis showed that hs-CRP(OR=1.009, 95% CI 1.003-1.016, P=0.005), primary PCI(OR=2.133, 95% CI 1.532-4.178, P=0.037) and peri-operative hypotension(OR=3.176, 95%CI 1.416-7.126, P=0.005) were the independent risk factors for CIN. Conclusion: The intensive atorvastatin medication could not prevent CIN in patients with high level of hs-CRP after PCI.