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HIGH DOSES OF STATINS BEFORE PERCUTANEOUS CORONARY INTERVENTION: WHETHER THERE ARE REASONS TO USE?

https://doi.org/10.20996/1819-6446-2017-13-4-532-540

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Abstract

The results of prospective randomized clinical trials planned to assess the efficacy of using statins in high doses before percutaneous coronary interventions (PCI) are presented in the review. The effect of this approach on the severity of myocardial damage and clinical outcomes in planned PCI in patients with stable ischemic heart disease (IHD) and early PCI in acute coronary syndrome (ACS) without stable ST-segment elevation was found. The results of the trials planned to study the incidence of contrast-induced nephropathy as well as data from meta-analyzes of conducted clinical trials are demonstrated.

According to the accumulated facts, taking high doses of statins before PCI can contribute to reduce myocardial damage with a decrease in the risk of periprocedural myocardial infarction. This effect was demonstrated in the planned coronary stenting in patients with stable IHD and in PCI in the first days of treatment of ACS without the stable ST-segment elevation. It was found both in patients who had not previously taken statins and in patients permanently treated with statins. The additional expected benefit of using a high dose of statins prior to PCI is the prevention of contrast-induced nephropathy. However, due to the limited evidence base, there is no consensus on the advisability of such an approach in current clinical guidelines. 

About the Authors

I. S. Yavelov
National Medical Research Centre for Preventive Medicine
Russian Federation

MD, PhD, Leading Researcher, Department of Clinical Cardiology and Molecular Genetics,

Petroverigsky per. 10, Moscow, 101990



M. V. Zhatkina
National Medical Research Centre for Preventive Medicine
Russian Federation

MD, Resident,

Petroverigsky per. 10, Moscow, 101990



O. M. Drapkina
National Medical Research Centre for Preventive Medicine
Russian Federation

MD, PhD, Professor, Corresponding Member of Russian Academy of Science, Acting Director,

Petroverigsky per. 10, Moscow, 101990



A. Yu. Gorshkov
National Medical Research Centre for Preventive Medicine
Russian Federation

MD, PhD, Head of Department of Emergency Cardiology with an Intensive Care Unit,

Petroverigsky per. 10, Moscow, 101990



N. O. Myasnikova
Pirogov Russian National Research Medical University
Russian Federation

Sixth-Year Student,

Ostrovitianova ul. 1, Moscow, 117997



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For citation:


Yavelov I.S., Zhatkina M.V., Drapkina O.M., Gorshkov A.Y., Myasnikova N.O. HIGH DOSES OF STATINS BEFORE PERCUTANEOUS CORONARY INTERVENTION: WHETHER THERE ARE REASONS TO USE? Rational Pharmacotherapy in Cardiology. 2017;13(4):532-540. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-4-532-540

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ISSN 1819-6446 (Print)
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