ADMINISTRATION OF LOADING DOSES OF STATINS FOR PREVENTION OF CONTRAST-INDUCED KIDNEY INJURY DURING ENDOVASCULAR INTERVENTIONS IN PATIENTS WITH ISCHEMIC HEART DISEASE

Abstract

Percutaneous coronary interventions have become a key method of revascularization in patients with coronary artery disease. Contrast-induced nephropathy is one of the main complications in patients who undergo coronary angiography and percutaneous coronary intervention. Loading doses of statins are often used for the purpose of nephroprotection. However, a clear available algorithm for prescribing statins for the prevention of acute contrast-induced kidney injury has not been identified. The purpose: to evaluate the effectiveness of high loading doses of statins (atorvastatin and rosuvastatin) to prevent acute contrast-induced kidney injury in patients with chronic ischemic heart disease during planned endovascular treatment.Material and Methods. Patients with clinical manifestations of FC II and III angina pectoris and hemodynamically significant stenoses of the coronary arteries were referred for a planned endovascular myocardial revascularization. Two groups of patients were assigned based on the intake of synthetic statins: atorvastatin and rosuvastatin. Before the endovascular intervention, patients were administered with high loading doses of statins. All patients underwent general clinical examination, routine assessment of creatinine levels, other blood tests, assessment of glomerular filtration rate, and control of lipid profile of blood.Conclusion. The incidence rate of contrast-induced kidney injury in patients with coronary artery disease, administered with loading doses of rosuvastatin, in the course of planned percutaneous coronary intervention was lower compared with the loading therapy of atorvastatin: 3.33 and 12.12%, respectively. On average, an increase in creatinine concentration to the maximum level occurred more often in the group of patients administered with a loading dose of atorvastatin than in the other group administered with a loading dose of rosuvastatin (14.3 versus 8.1%, p=0.024). A decrease in renal function in terms of GFR of less than 60 mL/min/1.73 m2 on day 5 was observed in 12 patients (34.3%) in the first group versus 9 patients (27.3%) in the second group. Therapy with loading doses of rosuvastatin before endovascular myocardial revascularization was more effective than treatment of patients with atorvastatin.