Effect of different doses of Atorvastatin in contrast-induced nephropathy

Objective To observe the mitigative effect and mechanism of different doses of Atorvastatin on renal impairment caused by contrast agent in patients with acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).Methods A total of 80 ACS patients underwent PCI were randomly divided into 20 mg Atorvastatin group(n=40)and 40 mg Atorvastatin group.Patients took 40 mg or 20 mg Atorvastatin daily 2 or 3 days before PCI.The levels of high-sensitivity CRP(hsCRP),cystain C(CysC),serum creatinine(Scr),blood urea nitrogen(BUN),as well as urinary α1-microglobulin(α1-MG),transferring(TRF)and microalbumin(mALB)were detected at 8 h before and 1 and 2 days after PCI,respectively.The creatinine clearance rate(Ccr)and glomerular filtration rate(GFR)were calculated,and the statistical analysis was performed.Results ①None of CIN patient was not found in 40 mg Atorvastatin group,while the incidence of CIN was 2.50% in 20 mg Atorvastatin group.②α1-MG,Scr and CysC were significantly increased in both 2 groups at 1 day after PCI(all P0.05),while Ccr and GFR were significantly decreased(both P0.05).α1-MG and CysC of two groups significantly decreased 2 days after PCI(all P0.05),as well as Ccr and GFR were significantly increased at the same time(both P0.05).③One day after PCI,the hsCRP levels of two groups were significantly higher than those of preoperation(all P0.05).No statistical difference was found between the hsCRP level at 1 day and 2 days after PCI in both two groups.④There was no significant difference of BUN,TRF,mALB,Scr,Ccr,CysC,GFR and hsCRP between two groups(all P0.05).Conclusion Pretreatment with Atorvastatin 2 to 3 days before PCI can effectively alleviate the renal impairment caused by contrast agent.Its mechanism may relate to the relief of anti-inflammation and the improvement of vascular endothelial function.