An 80-mg dose of atorvastatin administered 12 hours before angioplasty, followed by a 40-mg dose administered 2 hours before the procedure significantly reduces the risk of major cardiovascular events during the month after the intervention, according to the results of The Atorvastatin for Reduction of Myocardial Damage during Angioplasty-Acute Coronary Syndromes (ARMYDA-ACS) trial.
An 80-mg dose of atorvastatin administered 12 hours before angioplasty, followed by a 40-mg dose administered 2 hours before the procedure significantly reduces the risk of major cardiovascular events during the month after the intervention, according to Germano Di Sciascio, MD, professor and chairman of cardiology and director of cardiovascular sciences, Campus Bio-Medico University of Rome, Italy.
"Lipid-independent pleiotropic actions of atorvastatin may explain such rapid effects," Dr Di Sciascio said. Anti-inflammatory, antithrombotic, or vascular effects that improve outcomes may be responsible for the rapid effect of atorvastatin in this setting, he added.
The primary end point was occurrence of death, MI, or need for revascularization at 30 days after angioplasty.
Seventeen percent of placebo recipients versus 5% of atorvastatin-treated patients met the primary end point. After multivariate adjustment, this difference amounted to an 88% reduction (P=.004) in major cardiovascular events with atorvastatin pretreatment. "This was mostly driven by a 70% reduction in peri-procedural MI in the atorvastatin group," Dr Di Sciascio said.
The markers of cardiac injury, troponin-I and creatine kinase-MB, were significantly lower in the atorvastatin group compared with placebo when measured 30 days after intervention.
Patients on current statin therapy were excluded from the study; so it is unclear whether patients on chronic statin treatment would have a clinical benefit similar to the one observed with acute administration, Dr Di Sciascio said.
The results of the ARMYDA-ACS trial have since been published in the Journal of the American College of Cardiology (2007;49:1272–1278).