Effect of different statins on the renal function of acute coronary syndrome after intervention

Objective To investigate the mitigation effect and possible mechanism of different doses of rosuvastatin and atorvastatin on contrast-induced renal impairment in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).Methods A total of 120 ACS patients with PCI were divided into three groups:high dose rosuvastatin group (n =40),high dose atorvastatin group (n =40) and the conventional dose group(n =40).The levels of high-sensitivity C-reactive protein (hsCRP),serum creatinine (Scr),blood urea nitrogen (BUN),serum cystatin C (CysC),urinary α1-microglobulin (α1-MG),microalbumin (mALB) and urine osmolality were detected.Results ①The baseline data of the three groups before coronary intervention and their situation has no significant difference (P ＞ 0.05),thus the three groups were comparable.②Compared with the preoperative indeses,the levels of BUN,Scr,urine osmolality in all the three groups on 1 st day after PCI were not significandy different (P ＞ 0.05),the level of GFR decreased (P ＜ 0.05) and the levels of CysC,α1-MG,mALB were significantly increased.The levels of GFR decreased and the levels of CysC,α1-MG,mALB in the two high dose groups were lower than those in the conventional dose group (P ＜ 0.05),but there was no significant difference between the two high dose groups (P ＞ 0.05) ; compared with the indexes on 1 st day after PIC,the levels of BUN,Scr,urine osmolality in all the three groups on 2nd day after PCI were not significantly different (P ＞ 0.05),the level of GFR increased (P ＜ 0.05) and the levels of CysC,α1-MG,mALB decreased.The levels of CysC,α1-MG,mALB in the two high dose groups were lower than those in the conventional dose group (P ＜ 0.05),but there was no significant difference between the two high dose groups (P ＞ 0.05).③The levels of hsCRP on 1 st day after PIC and before operation,on 2nd day after PIC and on 1 st day after PIC were evaluated (P ＜0.05) ; the elevated levels of hsCRP in the two high dose groups were lower than those in the conventional dose group,but there was no significant difference between the two high dose groups (P ＞ 0.05).Conclusions Pretreatment with high dose statins before PIC is more effective on reducing contrast-induced renal impairment than pretreatment with conventional dose stains.The mechanism maybe related to the reduction of inflammation and the improvement of vascular endothelial function; Cys-C,α1-MG,mALB may be used as monitoring indicators of early renal impairment. Key words: Rosuvastatin ;  Atorvastatin ;  Acute coronary syndrome ;  High-sensitivity C-reactive protein